Forefoot & Toe Fracture

The forefoot has 5 metatarsal bones and 14 phalanges (toe bones). There are 3 phalanges in each toe, except for the first toe, which has two.

All the bones in the forefoot are designed to work together when you walk. A fracture, or break, in any of these bones can be painful and impact how your foot functions.

Fractures of the toes and forefoot are quite common. Fractures can result from a direct blow to the foot – such as accidentally kicking something hard or dropping a heavy object on your toes. They can also result from the overuse and repetitive stress that comes with participating in high-impact sports like running and basketball.

Although fracturing a bone in your toe or forefoot can be quite painful – it rarely requires surgery. In most cases, a fracture will heal with rest, immobilisation in special shoe and a change in activities.

Fifth metatarsal (little toe) fracture can need special attention based on the location of the fracture. Avulsion fracture (ballerina fracture or dancer’s fracture) means part of the bone avulses due to the pull of attached ligament and tendon at the base of the metatarsal and these fractures are usually treated with weight bearing in walking boot unless the fragment is a large displaced fragment.

The other type of fifth metatarsal (little toe) fracture is a horizontal or transverse fracture through the junction of the base and shaft of the bone. This is sometimes called a “Jones fracture”. Since the blood supply to this area is scare they are more prone to healing problems. In some cases, a Jones fracture may not heal at all, a condition called non-union and when this happens, surgery is often required to treat the fracture.