From the Research
For a Zone 1 fifth metatarsal fracture, patients should typically avoid weight bearing for 7-8 weeks, with the use of a controlled ankle motion (CAM)-walker boot or a hard-soled shoe, as this has been shown to result in faster bone healing compared to other treatments. The treatment of Zone 1 fractures of the proximal fifth metatarsal is generally conservative, with the goal of protecting the fracture site and allowing for proper healing.
- Initially, use of a walking boot, cast, or stiff-soled shoe is recommended to protect the fracture site, as seen in the study by 1.
- During the non-weight bearing period, crutches, a knee scooter, or a walker should be used to keep weight off the injured foot.
- After the initial protection period, weight bearing can be gradually increased as tolerated, but should be guided by pain levels and clinical healing.
- Zone 1 fractures (avulsion fractures at the base of the fifth metatarsal) generally heal more quickly and reliably than Zone 2 or 3 fractures, which are more prone to delayed union or non-union, as discussed in the study by 2.
- The protective period allows the bone fragments to stabilize and begin forming a callus, which is essential for proper healing.
- Complete healing typically takes 6-8 weeks total, though athletes or those with higher physical demands may require longer protection to prevent re-injury, as noted in the study by 3.
- A study by 1 compared the use of a CAM-walker boot and a hard-soled shoe for the treatment of Zone 1 fractures, and found that the CAM-walker boot resulted in faster bone healing, with an average time to healing of 7.2 weeks compared to 8.6 weeks for the hard-soled shoe.
- Another study by 4 discussed the treatment of Zone 2 fractures, but this is not directly relevant to the treatment of Zone 1 fractures.
- The study by 2 provided a systematic review of the treatment of fractures of the base of the fifth metatarsal bone, and found that early functional therapy was effective for Zone 1 and Zone 2 fractures.
- The study by 3 discussed the anatomy, classification, treatment, and complications of proximal fifth metatarsal fractures, and recommended conservative treatment for Zone 1 fractures.