Fifth metatarsal bone
{{Short description|Long bone in the foot}}
{{Infobox bone
| Name = Fifth metatarsal bone
| Latin = os metatarsale V
| Image = Gray288.png
| Caption = The fifth metatarsal. (Left.)
| Image2 = Ospied-en.svg
| Caption2 = Bones of the right foot. Dorsal surface. Fifth metatarsal bone is the yellow bone farthest the right
| Articulations =
}}
The fifth metatarsal bone is a long bone in the foot, and is palpable along the distal outer edges of the feet. It is the second smallest of the five metatarsal bones. The fifth metatarsal is analogous to the fifth metacarpal bone in the hand.{{cite book |last1=Bojsen-Møller |first1=Finn |last2=Simonsen |first2=Erik B. |last3=Tranum-Jensen |first3=Jørgen| year=2001 |title=Bevægeapparatets anatomi |edition=12th |language=da |trans-title=Anatomy of the Locomotive Apparatus | isbn =978-87-628-0307-7|pages=246 |publisher=Munksgaard Danmark }}
As with the four other metatarsal bones it can be divided into three parts; a base, body and head.
The base is the part closest to the ankle and the head is closest to the toes. The narrowed part in the middle is referred to as the body (or shaft) of the bone. The bone is somewhat flat giving it two surfaces; the plantar (towards the sole of the foot) and the dorsal side (the area facing upwards while standing). These surfaces are rough for the attachment of ligaments. The bone is curved longitudinally, so as to be concave below, slightly convex above.
The base articulates behind, by a triangular surface cut obliquely in a transverse direction, with the cuboid; and medially, with the fourth metatarsal. The fifth metatarsal has a rough eminence on the lateral side of its base, known as the tuberosity or the styloid process. The plantar surface of the base is grooved for the tendon of the abductor digiti quinti.
The head articulates with the fifth proximal phalanx, the first bone in the fifth toe.
A strong band of the plantar aponeurosis connects the projecting part of the tuberosity with the lateral process of the tuberosity of the calcaneus.
Proximal fractures
File:Proximal fractures of 5th metatarsal.jpg
Proximal fractures of the fifth metatarsal are common,{{cite journal |journal= Journal of the American Academy of Orthopaedic Surgeons |title= Treatment Strategies for Acute Fractures and Nonunions of the Proximal Fifth Metatarsal |author1=Gary A. Rosenberg |author2=James J. Sferra |date= September–October 2000 |volume = 8 |number= 5 |pages= 332–338|doi= 10.5435/00124635-200009000-00007 |pmid= 11029561 |s2cid= 40453020 }} and are distinguished by their locations:
- A proximal diaphysis fracture is typically a stress fracture, commonly among athletes.{{cite journal| author=Bica D, Sprouse RA, Armen J| title=Diagnosis and Management of Common Foot Fractures. | journal=Am Fam Physician | year= 2016 | volume= 93 | issue= 3 | pages= 183–91 | pmid=26926612 | url=https://pubmed.ncbi.nlm.nih.gov/26926612 }}{{cite web|title=5th Metatarsal|url=https://www.aci.health.nsw.gov.au/networks/eci/clinical/clinical-resources/clinical-tools/orthopaedic-and-musculoskeletal/musculoskeletal-orthopaedic-guide/5th-metatarsal|website=Emergency Care Institute, New South Wales|date=2017-09-19|access-date=2019-07-29|archive-date=2019-07-29|archive-url=https://web.archive.org/web/20190729082357/https://www.aci.health.nsw.gov.au/networks/eci/clinical/clinical-resources/clinical-tools/orthopaedic-and-musculoskeletal/musculoskeletal-orthopaedic-guide/5th-metatarsal|url-status=dead}}
- A metaphysis fracture is also called a Jones fracture. Due to poor blood supply in this area, such a fracture sometimes does not heal and surgery is required.{{cite web|title=Toe and Forefoot Fractures|url=http://orthoinfo.aaos.org/topic.cfm?topic=a00165|website=OrthoInfo - AAOS|access-date=15 October 2017|date=June 2016|url-status=live|archive-url=https://web.archive.org/web/20171016013850/http://orthoinfo.aaos.org/topic.cfm?topic=a00165|archive-date=16 October 2017}}
- A tuberosity fracture is also called a pseudo-Jones fracture or a dancer's fracture.{{cite web |url= http://emedicine.medscape.com/article/825060-overview |title= Foot Fracture |author = Robert Silbergleit |publisher = Medscape.com |access-date= 19 October 2011}} It is typically an avulsion fracture.{{cite web |url= http://emedicine.medscape.com/article/825060-overview |title= Foot Fracture |author = Robert Silbergleit |publisher = Medscape.com |access-date= October 19, 2011}}
Normal anatomy that may simulate a fracture include mainly:
- The "apophysis", which is the secondary ossification center of the bone, and is normally present at 10 – 16 years of age.{{cite journal|last1=Deniz|first1=G.|last2=Kose|first2=O.|last3=Guneri|first3=B.|last4=Duygun|first4=F.|title=Traction apophysitis of the fifth metatarsal base in a child: Iselin's disease|journal=BMJ Case Reports|volume=2014|issue=may14 4|year=2014|pages=bcr2014204687|issn=1757-790X|doi=10.1136/bcr-2014-204687|pmid=24832713|pmc=4025211}}
- Os vesalianum, an accessory bone which is present in between 0.1 - 1% of the population.{{cite journal|last1=Nwawka|first1=O. Kenechi|last2=Hayashi|first2=Daichi|last3=Diaz|first3=Luis E.|last4=Goud|first4=Ajay R.|last5=Arndt|first5=William F.|last6=Roemer|first6=Frank W.|last7=Malguria|first7=Nagina|last8=Guermazi|first8=Ali|title=Sesamoids and accessory ossicles of the foot: anatomical variability and related pathology|journal=Insights into Imaging|volume=4|issue=5|year=2013|pages=581–593|issn=1869-4101|doi=10.1007/s13244-013-0277-1|pmid=24006205|pmc=3781258}}
Muscle attachments
{{multiple image
| image1 = Gray268.png
| width1 = 130
| caption1 = Muscle attachments (seen from above)
| image2 = Gray269.png
| width2 = 133
| caption2 = Muscle attachments (seen from below)
}}
The tendon of the fibularis tertius inserts on the medial part of the dorsal surface and the fibularis brevis on the dorsal surface of the tuberosity.
The plantar surface of the base is grooved for the tendon of the abductor digiti quinti, and gives origin to the flexor digiti minimi brevis.
The fourth dorsal interosseus muscle originates from the medial side of shaft. The function of the muscle is to spread the toes.{{cite book |last1=Bojsen-Møller |first1=Finn |last2=Simonsen |first2=Erik B. |last3=Tranum-Jensen |first3=Jørgen| year=2001 |title=Bevægeapparatets anatomi |edition=12th |language=da |trans-title=Anatomy of the Locomotive Apparatus | isbn =978-87-628-0307-7|pages=300–301 |publisher=Munksgaard Danmark }}
The third Plantar interosseus muscle originates from the medial side of the base and shaft of the fifth metatarsal. The function of the muscle is to move the fourth toe medially and move the toes together.
The horizontal head of the adductor hallucis from the deep transverse metatarsal ligament, a narrow band which runs across and connects together the heads of all the metatarsal bones.
| class="sortable wikitable"
! Muscle | Direction | Attachment{{cite book |last1=Bojsen-Møller |first1=Finn |last2=Simonsen |first2=Erik B. |last3=Tranum-Jensen |first3=Jørgen| year=2001 |title=Bevægeapparatets anatomi |edition=12th |language=da |trans-title=Anatomy of the Locomotive Apparatus | isbn =978-87-628-0307-7|pages=364–367 |publisher=Munksgaard Danmark }} |
| Fibularis tertius | Insertion | Dorsal side of the basis |
| Fibularis brevis | Insertion | Tuberosity |
| Flexor digiti minimi brevis | Origin | Plantar surface of the base |
| Dorsal interossei IV | Origin | Medial side of the shaft |
| Plantar interossei III | Origin | Medial side of the base and shaft |
| Horizontal head of adductor hallucis | Origin | Deep transverse metatarsal ligament |
Additional images
File:Gray290.png|Skeleton of foot. Medial aspect.
File:Gray360.png|Oblique section of left intertarsal and tarsometatarsal articulations, showing the synovial cavities.
File:Foot bones - tarsus, metatarsus.jpg|Foot bones – tarsus, metatarsus
File:Foot bones - metatarsus and phalanges.jpg|Foot bones – metatarsus and phalanges
File:Metatarsus.jpg|Metatarsus
References
{{Portal bar|Anatomy}}
{{Gray's}}
{{reflist}}
{{Commons category|Fifth metatarsal bone}}
{{Bones of lower extremity}}