Management of fractures of the base of the fifth metatarsal distal to the tuberosity

Proximal fifth metatarsal fractures distal to the tuberosity are troublesome fractures to manage with a high incidence of delayed union and non-union. We present our study of 32 patients with this fracture who were followed up for a mean of 16 months. This is one of the largest reported series of such fractures. These fractures were classified as acute fractures (14 fractures), fractures with features of delayed union (15 fractures) and fractures with features of non-union (three fractures) at presentation according to the classification used by Torg in 1984. These patients were treated in a plaster cast and mobilised either non-weight bearing or with variations of weight bearing. Our findings correspond with those observed by Torg. Prevailing guidelines for the management of these fractures are ambiguous. A standardized classification is important because there is great variability in the types of fractures and appropriate treatment. The treatment of choice is suggested in view of the clinical and radiological findings at presentation.