In short
The fifth metatarsal is the long bone on the outer edge of the foot leading to the little toe, and is one of the most commonly broken bones in the foot, often after rolling the ankle. Most fractures, especially small avulsion fractures at the base, heal well in a supportive boot or shoe. Fractures in the 'Jones' zone and stress fractures have a poorer blood supply and a higher risk of not healing, so they may need longer protection or surgery with a screw.
Types of fifth metatarsal fracture
Fractures are grouped by where they occur, because this affects healing:
- Zone 1: avulsion fracture at the very base, where the peroneus brevis tendon pulls off a fragment of bone during an ankle twist. The most common type, and usually heals well.
- Zone 2: Jones fracture, slightly further along where the blood supply is poorer, so healing is slower and less reliable.
- Zone 3: stress fracture of the shaft from repeated overload, sometimes linked with a high-arched foot.
- Shaft and neck fractures further along the bone, often from a direct blow or twisting.
Symptoms
- Pain, swelling and bruising on the outer edge of the foot
- Difficulty walking
- Tenderness over the bone
Treatment
- Walking boot or stiff-soled shoe, walking as pain allows, for most fractures
- Protected weight-bearing for Jones and stress fractures
- Follow-up X-rays to confirm healing
- Surgery, usually a screw, for non-union, displaced fractures and selected athletes. Prof Mason’s team has published on percutaneous screw fixation for fifth metatarsal base non-union.
Common questions
Do I need a cast?
Most fifth metatarsal fractures are treated in a walking boot or stiff-soled shoe, walking as comfort allows. Jones and stress fractures may need a period of protected weight-bearing.
When is surgery needed?
Surgery is considered for fractures that have not healed (non-union), some Jones and stress fractures in athletes wanting a faster, more reliable return to sport, and displaced fractures. It usually involves a screw inserted through a small incision.
How long does it take to heal?
Avulsion fractures usually heal in six to eight weeks. Jones and stress fractures can take longer, sometimes three months or more.
Talk it through with a specialist
Consultations at Spire Liverpool, Salford and the Isle of Man. New patients £250.
Consultant Foot and Ankle Surgeon, MB BCh, PhD, FRCS (Tr&Orth), FRCS (Glasg), SFHEA, FFSTEd. GMC 6074953. Hunterian Professor, Royal College of Surgeons of England.
Page last reviewed 25 October 2026. This information is general and does not replace an assessment.
Prof Mason's published research on this topic
Peer-reviewed papers by Prof Mason and his colleagues. Links open the paper or its PubMed record.
- Chapman J, Gupta S, Choudhary Z, Davies T, Airey G, Mason L. Is the diagnosis of 5th metatarsal fracture subtype consistent? An inter-observer reliability study. Foot & Ankle Orthopaedics, 2024.
- Grant M, Molloy A, Mason LW. The use of percutaneous screw fixation without fracture site preparation in the treatment of 5th metatarsal base non-union. Journal of Foot and Ankle Surgery, 2020.