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You are seeing a 15-year-old basketball player who presents with pain and tenderness at the proximal 5thmetatarsal after an inversion injury.
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You are seeing a 15-year-old basketball player who presents with pain and tenderness at the proximal 5thmetatarsal after an inversion injury.
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March 26, 2025 at 2:01 pm
B) Fractures of the tuberosity (aka “Dancer’s fracture”) are treated symptomatically with a walking boot, RICE, NSAIDs, and orthopedic follow-up
Fractures of the proximal 5th metatarsal commonly result from an inversion injury and can be associated with a lateral ankle sprain. The most proximal portion of the metatarsal, the tuberosity, articulates with the cuboid and has good blood supply from multiple vessels. Fracture in this area (aka “Dancer’s fracture”) has low risk of non-union due to this excellent blood supply. The area distal the tuberosity, the intermetatarsal zone and the proximal diaphysis, depends solely on the single nutrient artery for its blood supply. Fractures in these areas carry more risk of poor healing and nonunion. However, emergency referral is rarely indicated; initial treatment is similar to tuberosity fractures: walking boot, crutches, RICE, NSAIDs, and close orthopedic follow-up for possible surgery. Children may have an apophysis oriented parallel to the long axis of the metatarsal that can be mistaken for a fracture. Radiographs of the uninjured foot for comparison can help differentiate apophysis from fracture.