Excision of symptomatic nonunions of proximal fifth metatarsal avulsion fractures in elite athletes

J. David Ritchie, J. Christopher Shaver, Robert B. Anderson, Steven J. Lawrence, Scott D. Mair

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Background: An avulsion fracture of the proximal fifth metatarsal may result in a symptomatic nonunion and hinder athletic performance. Nonoperative management is often successful in alleviating symptoms. When symptoms persist, surgery can be undertaken to repair the nonunion or excise the avulsed fragment.Purpose: The excision of the avulsed bone fragment is evaluated in the management of symptomatic nonunions.Study Design: Case series; Level of evidence, 4.Methods: Excision of the avulsed fifth metatarsal fragment was performed in 6 male high-performance athletes with symptomatic nonunions. The remaining edge of bone was contoured and smoothed.Results: All 6 patients experienced an uneventful operation and recovery, returning to competitive play at a mean of 11.7 weeks. Activity-related pain and discomfort abated after the excision and rehabilitation. No surgical complications were noted.Conclusion: Surgical excision of the avulsed fragment from the proximal fifth metatarsal is a safe and effective alternative intervention when nonoperative methods fail.

Original languageEnglish
Pages (from-to)2466-2469
Number of pages4
JournalAmerican Journal of Sports Medicine
Issue number11
StatePublished - Nov 2011


  • athletes
  • avulsion
  • excision
  • fibrous union
  • fifth metatarsal
  • nonunion

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation


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