[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Lower limb](https://durgical.com/en/anatomy/region/lower-limb/) › Fifth metatarsal [Skeletal system](https://durgical.com/en/anatomy/system/skeletal-system/) · [Lower limb](https://durgical.com/en/anatomy/region/lower-limb/) # Fifth metatarsal The fifth metatarsal is the outer long bone of the forefoot, behind the little toe; a tendon attaches to the bump at its base. Official name: Fifth [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=lower_limb&select=metatarsal_5&side=r) Opens in the Durgical app, no sign-up needed. ## What it is The outer long bone of the forefoot, behind the little toe. Its base has a bump (tuberosity) where the [fibularis brevis tendon](https://durgical.com/en/anatomy/tendon-of-fibularis-brevis/) attaches. ## What it does Forms the outer edge of the foot and helps with balance when standing and walking. ## Key points - Three proximal fracture zones: 1 tuberosity avulsion (pseudo-Jones), 2 metaphyseal–diaphyseal junction (Jones fracture, watershed blood supply), 3 proximal shaft stress fracture - A zone 1 fracture line enters the joint with the cuboid; a zone 2 (Jones) line enters the joint between the fourth and fifth bases - In inversion injuries, [fibularis brevis](https://durgical.com/en/anatomy/fibularis-brevis-muscle/) and the lateral band of the plantar fascia pull on the tuberosity ## Key facts **Joints with** Cuboid; fourth metatarsal; proximal phalanx of little toe **Landmarks** Tuberosity on base (fibularis brevis); fibularis tertius on dorsal base; Jones fracture at metaphyseal–diaphyseal junction ## Relations **Behind** [Cuboid](https://durgical.com/en/anatomy/cuboid-bone/) at the fifth tarsometatarsal joint **In front** Proximal phalanx of the [little toe](https://durgical.com/en/anatomy/little-toe/) **Medial** [Fourth metatarsal](https://durgical.com/en/anatomy/fourth/) at the intermetatarsal joint; fourth dorsal and third [plantar interossei](https://durgical.com/en/anatomy/plantar-interossei-muscles/) **Lateral** Subcutaneous outer border; the [sural nerve](https://durgical.com/en/anatomy/sural-nerve/) runs along the lateral foot near the base and is at risk in surgery **Below** Abductor digiti minimi and flexor digiti minimi brevis; the lateral band of the [plantar fascia](https://durgical.com/en/anatomy/plantar-aponeurosis/) to the tuberosity **Above** [Fibularis tertius](https://durgical.com/en/anatomy/fibularis-tertius-muscle/) on the dorsal base; [extensor digitorum longus](https://durgical.com/en/anatomy/extensor-digitorum-longus/) tendon to the little toe ## How to find it The tuberosity at the base is the most prominent point of the outer border of the foot, about halfway between the heel and the little toe; the shaft is followed along the outer edge to the head. ## Examination - Ottawa foot rules: tenderness at the base of the fifth metatarsal or at the [navicular](https://durgical.com/en/anatomy/navicular-bone/), or inability to bear weight, indicates foot X-rays ## On imaging AP, oblique and lateral foot views: the zone is set by where the line runs. In children the apophysis is a thin flake parallel to the shaft, whereas a fracture line runs across the bone. Os vesalianum and os peroneum are smooth corticated ossicles nearby. ## Common problems - Avulsion fracture: the tip of the base breaks off when the ankle rolls. It usually heals well. - Jones fracture: a break a little further along, where the blood supply is poor, so it often heals slowly. - Stress fractures of the shaft in athletes. ## How it is diagnosed A physical exam; X-rays show where the break is. CT or MRI for slow-healing or stress fractures. ## Treatment - Avulsion fractures: a stiff shoe or boot and gradual walking. - Jones fractures: a cast or boot with no weight on the foot for several weeks, or surgery with a screw, often chosen for athletes. - Fractures that do not heal: surgery with a screw, sometimes with a bone graft from the patient or a donor. ## Clinical notes - Jones fractures have high rates of delayed union and refracture; athletes are often treated with an intramedullary screw - Dancer's fracture: a spiral fracture of the distal shaft from rolling over a plantarflexed foot - A cavovarus foot overloads the lateral border and predisposes to fifth metatarsal stress fractures ## Anatomical variants - Os vesalianum: an accessory ossicle beside the tuberosity, near the fibularis brevis insertion; its smooth, corticated edges tell it apart from an avulsion fracture ## Development The tuberosity apophysis appears around the start of adolescence and fuses a few years later; traction apophysitis here is Iselin disease. ## Related conditions - [Metatarsal fractures (including stress fractures)](https://durgical.com/en/conditions/metatarsal-fractures/) - [Mycetoma (actinomycetoma and eumycetoma)](https://durgical.com/en/conditions/mycetoma/) ## Test yourself Think of the answer, then tap the question to see it. ## Which tendon inserts on the tuberosity of the fifth metatarsal base? The fibularis brevis tendon; the lateral band of the plantar fascia also pulls here. ## What is a Jones fracture and why does it heal poorly? A fracture at the metaphyseal–diaphyseal junction of the fifth metatarsal (zone 2), a watershed area with poor blood supply. ## How does a tuberosity avulsion (zone 1) differ from a Jones fracture in which joint the line enters? Zone 1 enters the joint with the cuboid; a Jones (zone 2) fracture enters the joint between the fourth and fifth metatarsal bases. ## What is Iselin disease? Traction apophysitis at the tuberosity apophysis of the fifth metatarsal in adolescents. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/anatomy/fifth/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** os metatarsi V TA2 1496 **Official Spanish (DeCS)** Quinto metatarsiano DeCS D008682 **English (TA2)** Fifth ## Related - [Cuboid](https://durgical.com/en/anatomy/cuboid-bone/) - [Little toe](https://durgical.com/en/anatomy/little-toe/) - [Fibularis brevis tendon](https://durgical.com/en/anatomy/tendon-of-fibularis-brevis/) - [Fibularis tertius](https://durgical.com/en/anatomy/fibularis-tertius-muscle/) - [Abductor digiti minimi](https://durgical.com/en/anatomy/abductor-digiti-minimi-of-foot/) - [Adductor hallucis](https://durgical.com/en/anatomy/adductor-hallucis/) - [Dorsal interossei](https://durgical.com/en/anatomy/dorsal-interossei-muscles-of-foot/) - [Fibular retinacula](https://durgical.com/en/anatomy/superior-fibular-retinaculum/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=22943&filter=ths_termall&q=Huesos%20Metatarsianos); [Anatomy, Bony Pelvis and Lower Limb: Metatarsal Bones](https://www.ncbi.nlm.nih.gov/books/NBK549872/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/fifth/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/fifth/