From the Research
A short leg walking boot, specifically a CAM-walker boot, is the recommended type of splint for a 5th metatarsal fracture, as it allows for earlier signs of complete healing and similar clinical and functional results compared to other treatments. The choice of splint depends on the fracture location, severity, and displacement. For non-displaced or minimally displaced fractures at the base of the 5th metatarsal (Jones fractures), a short leg walking boot with weight-bearing restrictions for 6-8 weeks is often sufficient 1.
Key Considerations
- Fracture location: The location of the fracture on the 5th metatarsal bone is crucial in determining the type of splint to use.
- Fracture severity and displacement: The severity and displacement of the fracture also play a significant role in choosing the appropriate splint.
- Treatment goals: The primary goal of treatment is to promote proper bone healing while providing adequate support to the lateral aspect of the foot.
Recommended Treatment
- For non-displaced or minimally displaced fractures, a short leg walking boot with weight-bearing restrictions for 6-8 weeks is recommended 1.
- For more complex or displaced fractures, a non-weight-bearing below-knee cast or splint may be necessary for 4-6 weeks, followed by a walking boot for an additional 2-4 weeks.
- Elevation of the foot above heart level, ice application, and appropriate pain management with NSAIDs are also recommended during treatment.
Evidence-Based Decision
The recommendation for a CAM-walker boot is based on a study published in 2020, which compared the outcomes of using a hard-soled shoe versus a CAM-walker boot for zone 1 fractures of the proximal fifth metatarsal 1. The study found that patients treated with a CAM-walker boot demonstrated earlier signs of complete healing, although similar clinical and functional results were achieved with both treatments. This study provides the most recent and highest quality evidence for the treatment of 5th metatarsal fractures, making it the basis for the recommended treatment.