2. 46 YOM pw pain in right
foot. Pain began this
morning when he woke
up. Pt reports playing a
lot of basketball
yesterday but denies
trauma. Pain is located
on side of his foot near
his small toe, described
as severe and
exacerbated by walking.
No relievers reported.
 T 97.2 P 115 BP 126/84 O2
99%
 Gen: Mild discomfort 2/2
pain in foot. GCS 15
 CV: Tachycardic, RR, no
m/r/g
 Pulm: Lungs CTA bilat
 Abd: NTND/BS nL
 MSK: No bony
abnormalities on feet
bilaterally. LE bilaterally NV
intact. TTP at base of 5th MT
(R) w decreased ROM 2/2
pain. No TTP malleoli or
calcaneus (R).

4. 1. Orange arrow: linear, non-displaced fracture at proximal 5th MT
2. Fracture is MT tuberosity.
3. No fracture seen at metaphyseal-diaphyseal junction (Jones fracture)

5. Ice, Analgesics, Elevate
Place in hard soled shoe
Crutches optional based on severity of pain but pt
does not have to be non-weight bearing.
Follow up with Orthopedics in 1-2 weeks.

6.  Pseudo-Jones fracture is an avulsion fracture of the base of the 5th
metatarsal involving the tuberosity
 • Pseudo-Jones fracture is the most common fracture of the base of the 5th
 metatarsal, accounting for over 90% of 5th Metatarsal fractures

•
Avulsion at the attachment site of the peroneus brevis
Should not be confused with a Jones fracture as treatment is different.
 • Patient's with Pseudo-Jones fracture are allowed to bear weight while
patient's with Jones fractures can not.
 • A Jones fracture is a fracture of the base of the 5th metatarsal at the
 metaphyseal-diaphyseal junction.
 • Jones fracture, although they can be treated with a short leg cast, nonunion
 is a concern with a Jones fracture, and hence, they may eventually
 require screw fixation.

•

7. This is an avulsion fracture of the 5th MT tuberosity.
MOI: forcible inversion of the foot in plantar flexion.
( A direct blow to the tuberosity can cause a
comminuted fracture.)
The fracture occurs where a the peroneus brevis
tendon tendon attaches to the bone.
Treatment: Hard soled boot, f/u with Ortho in 1-2
weeks.
Also called a Dancer’s Fracture

8.  A Jones fracture occurs at the proximal end of the
metatarsal near the metadiaphyseal junction (greater than
15 mm distal to the proximal end of the 5th metatarsal).
 MOI: Typically a result of an upward force or a direct blow
to the area.
 Jones fracture often does not heal bc this is an area of poor
blood supply. And, there are various tendons attaching in
the area pulling the fracture apart causing motion at the
site of healing.
 Treatment: Immobilize, strict non-weight bearing, f/u
with Ortho in 5-7 days

9. 
Tintinalli's Emergency Medicine: A Comprehensive Study
Guide. O. John Ma, M.D., Judith E. Tintinalli, J. Stephan
Stapczynski, David M. Cline. McGraw-Hill Professional
Publishing: 2010.

Wheeless Textbook of Orthopedics. Clifford R Wheeless,
MD.

Radiographics. Forefoot Pain Involving the Metatarsal
Region: Differential Diagnosis with MR Imaging. Carol J.
Ashman, MD, Rosemary J. Klecker, MD and Joseph S. Yu,
MD: 2001.

Skimboarder's Toe: Findings on High-Field MRI Am. J.
Roentgenol. May 1, 2005 184:5 1481-1485.

10. 
Tintinalli's Emergency Medicine: A Comprehensive Study
Guide. O. John Ma, M.D., Judith E. Tintinalli, J. Stephan
Stapczynski, David M. Cline. McGraw-Hill Professional
Publishing: 2010.

Wheeless Textbook of Orthopedics. Clifford R Wheeless,
MD.

Radiographics. Forefoot Pain Involving the Metatarsal
Region: Differential Diagnosis with MR Imaging. Carol J.
Ashman, MD, Rosemary J. Klecker, MD and Joseph S. Yu,
MD: 2001.

Skimboarder's Toe: Findings on High-Field MRI Am. J.
Roentgenol. May 1, 2005 184:5 1481-1485.