The abductor digiti minimi of the foot arises from the lateral and plantar surfaces of the calcaneus and the plantar fascia and inserts via a flat tendon on the lateral surface of the base of the proximal phalanx of the fifth toe and the tuberosity of the fifth metatarsal, often sharing an attachment with the flexor digiti minimi brevis. It forms the lateral border of the sole of the foot.
The abductor digiti minimi tendon and its proximal attachment to the fifth metatarsal base are relevant in avulsion fracture of the fifth metatarsal styloid (pseudo-Jones fracture), where the peroneus brevis tendon and sometimes the abductor digiti minimi avulse the tuberosity during forced inversion. Distinguishing this tuberosity avulsion from a Jones fracture at the metaphyseal-diaphyseal junction is critical as management differs entirely: tuberosity fractures are managed conservatively while Jones fractures require prolonged protected weight-bearing or surgical fixation.
Forced inversion avulses the fifth metatarsal tuberosity by the pull of the peroneus brevis and abductor digiti minimi tendons, producing lateral foot pain; this pseudo-Jones fracture is managed conservatively with a supportive boot unlike the true Jones fracture at the metaphyseal-diaphyseal junction.
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