NJ Nets Center Brook Lopez Out with 5th Metatarsal Fracture
New Jersey Nets Center, Brook Lopez has a Jones fracture. When will he return to this already shortened season?
The metatarsal are a series of bones in the foot that lead to the toes. There are five metatarsal in each foot, correlating to the five toes. The fifth metatarsal interacts with the fifth or pinky toe. This bone is particularly important, as breaks at the base of this bone can be difficult to heal.
To understand breaks of the fifth metatarsal, one needs to know the type of break present. The breaks at the base of the fifth metatarsal are divided into three types:
Type 1 – an avulsion break off the base of the fifth metatarsal. This break usually heals with little problem.
Type 2 (also known as a Jones Fracture) – a break of the base of the 5th metatarsal that goes into the area where the 4th and 5th metatarsal interact with one another. This fracture is difficult to treat, as the blood supply to this area of the 5th metatarsal is poor.
Type 3 (also known as a Dancer’s fracture) – a break of the long shaft of the 5th metatarsal.
Fractures of the base of the 5th metatarsal occur when the ankle is twisted in inversion, or the ankle rolls outward. Extra pressure is placed on the base of the 5th metatarsal, causing it to break.
A person who breaks their 5th metatarsal may have pain at the base of the bone, with swelling pain, and possible difficulty with walking.
WHEN TO SEEK MEDICAL CARE
If you suspect that you have a 5th metatarsal fracture, you should see an orthopaedic surgeon. They will require a thorough physical exam and x-rays will be needed to determine where the break is located.
Treatment varies depending on the location of the 5th metatarsal fracture and the type of break present.
Type 1 – an avulsion break off the base of the fifth metatarsal. This break usually heals with little problem. It usually requires a boot and walking cast for 4 weeks.
Type 2 (also known as a Jones Fracture) – a break of the base of the 5th metatarsal that goes into the area where the 4th and 5th metatarsal interact with one another. This fracture is difficult to treat, as the blood supply to this area of the 5th metatarsal is poor. The break can be treated with a cast or surgery. For those patients who decide to have a cast, they may be non-weight bearing on the injured leg for 12 or more weeks. There is approximately a 20% non healing rate of this fracture, when treated without surgery. With surgery, the patient is usually allowed to wear protective boots or insoles and walk 4 weeks following surgery. In surgery, a screw or plate with screws can be used to span the break and hold the pieces together.
Type 3 (also known as a Dancer’s fracture) – a break of the long shaft of the 5th metatarsal, This break can be treated in a non-weight bearing cast for approximately 6-8 weeks. It requires surgery if it has moved out of place, or is not positioned correctly.
Most patients with 5th metatarsal fractures are able to return to play. For type 1 and 3 breaks, return to competitive sports may take 3-4 months. For type 2 breaks, return to competitive play occurs 6-8 weeks after the surgery.
RETURN TO ACTIVITIES
Depending on the type of fracture Lopez has sustained, he should be back to football in 6-8 weeks.
A live surgical video can be seen at: http://www.youtube.com/NCOCatDuke
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