Casting a fifth metatarsal fracture

The fifth metatarsal runs along the outer side of the foot toward the little toe. Fractures near its base do not all behave alike, so the wording of the imaging report and the clinician's weight-bearing instructions matter.

A small piece can be pulled from the base during an ankle-twisting injury, while another fracture pattern occurs in an area with less favourable blood supply. A crack can also develop farther along the shaft after repeated loading. Examination and imaging distinguish these patterns.

A plaster or fibreglass cast restricts foot and ankle movement and can prevent unapproved loading. Some stable injuries can use removable support, whereas displacement, poor alignment or concern about healing may lead to closer monitoring or fracture fixation surgery. The treatment choice is not based on pain intensity alone.

Follow the prescribed weight-bearing status exactly and use crutches or another aid as taught. Keep the cast dry according to the team's instructions, elevate the foot when swelling builds, and move exposed toes gently if permitted. Never insert objects under the cast.

Check toe colour, warmth, feeling and movement each day. Avoid testing the fracture by walking without approval, even if pain eases. Attend follow-up imaging and clinical checks; support may change as tenderness, swelling and bone alignment evolve. Physiotherapy may later address ankle movement, strength, balance and a gradual return to activity.

Get urgent help if toes become cold, pale or blue, new numbness develops, toe movement is lost, or escalating pain and tightness do not improve with elevation. Sudden marked swelling, a new deformity or another injury while in the cast also needs prompt review.

Call the treating service if the cast cracks, softens, becomes soaked, slips or causes rubbing, burning, discharge or bad odour. Seek medical assessment for fever, spreading redness, calf swelling, chest pain or unexplained breathlessness.

Ask where the fracture lies, whether it is displaced, and why a cast, boot or operation is recommended. Confirm when weight may pass through the foot, which exercises are allowed, how healing will be checked and what is required before returning to work, driving or sport.