title: Fractures of the fifth metatarsal in children and adolescents.
abstract: OBJECTIVE
  Fractures of the fifth metatarsal are the most common metatarsal fractures in children. Their treatment is based on the adult literature. The purpose of our study was to identify the different types of fifth metatarsal fractures, to determine the mean time to healing, and to examine whether current adult recommendations can be extrapolated to children and adolescents.
  
  
  METHODS
  A total of 103 patients met the inclusion criteria. The fractures were classified according to location. Type I represented an apophyseal injury. Type II represented tubercle fractures with intra-articular extension. Type III injuries represented Jones fracture. Metatarsal neck and shaft fractures were included separately.
  
  
  RESULTS
  Apophyseal fractures did well with a short-leg walking cast for 3 to 6 weeks. Displaced intraarticular fractures had a significant delay in healing versus nondisplaced ones. Jones fractures had delays in healing if not treated surgically. Neck and shaft fractures did well with casting.
  
  
  CONCLUSIONS
  Most fractures of the fifth metatarsal in the pediatric population do well clinically after a course of walking cast, unless the fracture is an intra-articular displaced fracture type or the fracture occurs in the proximal diaphyseal area. Fixation of Jones fractures in active adolescents should be considered to allow faster return to regular activities and prevent refracture. We recommend non-weight bearing casts for all angulated or displaced intra-articular injuries to avoid delays in healing and angulation. From our series, it is evident that most pediatric fifth metatarsal fractures behave as those found in adults and can be treated similarly.
authors.affiliation: Orlando Regional Medical Center and Arnold Palmer Hospital for Children, Orlando, FL 32819, USA. jose.herrera@orhs.org
authors.forename: Jose A
authors.initials: JA
authors.lastname: Herrera-Soto
authors.forename: Michael
authors.initials: M
authors.lastname: Scherb
authors.forename: Michael F
authors.initials: MF
authors.lastname: Duffy
authors.forename: Jay C
authors.initials: JC
authors.lastname: Albright
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000145:classification* / Q000000981:diagnostic imaging / Q000628:therapy; D005592:Fracture Fixation / Q000379:methods; D017102:Fracture Healing; D050723:Fractures, Bone / Q000145:classification* / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000293:injuries*; D011859:Radiography; D012189:Retrospective Studies; D013997:Time Factors; D015599:Trauma Severity Indices