The five metatarsals form the forefoot between the tarsal bones and the toes, numbered 1 (great toe) to 5 (little toe). The head of the first metatarsal bears most forefoot loading, while the fifth metatarsal base is the most commonly avulsed in lateral ankle sprains.
Metatarsal fractures are common foot injuries. Fifth metatarsal fractures require distinction between three injury patterns: styloid avulsion (peroneus brevis, conservative), Jones fracture at the metaphyseal-diaphyseal junction (high non-union risk, fixation recommended in athletes), and diaphyseal stress fracture (activity modification, fixation for non-healing). March fractures are metatarsal stress fractures from sudden increase in walking, most common at the second and third metatarsal shafts.
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