Brandt R Gibson, DPM
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Podiatrist, Neuropathy Doctor, Father of 11 and Founder of Mountain West Foot & Ankle Institute
Soon after this loss to the Utah Jazz, Milwaukee Bucks point guard Brandon Jennings underwent surgery to repair a fifth metatarsal fracture.  After starting 114 games with the team, he is scheduled to be out 4-6 weeks.   He was injured the week before when he made a drive to the basket in the second quarter against San Antonio. Jennings was helped off the court but returned for the second half with no apparent problems.  Having fractured my own fifth metatarsal playing sports, I understand how he felt.  The difference is he went for surgery. 

When is surgery necessary for a fifth metatarsal fracture?
Following these simple steps, you can determine with your physician if a surgery may be necessary for a fifth metatarsal fracture:

1.  Is the fracture in good alignment?  It is very important that the bones in the foot be aligned anatomically and have good bone to bone contact.  If the bone contanct is insufficient, it will be difficult for the body to heal correctly.  If the alignment is bad or bone contact is insufficient, surgery should be performed to allow the quickest recovery.

2. Do you have good bone stock?  If the bone quality is poor, or your nutrition status is insufficient, it may lead to poor healing.  Improving your nutrition status doesn't require healing, but surgical correction can speed healing even in this condition.

3. Fracture location?  In the fifth metatarsal there are areas that heal poorly, or have a high probability of needing surgery.  A Jones fracture is one type that should undergo surgery.  Based on location, you may require surgery to recover as desired.

4.  How fast do you need to recover?  If you need to recover more quickly for a sport or other activity, the surest way is to undergo surgery.  Although this may lead to increased pain initially, it stabilizes the fracture and allows quicker recovery.  Professional athletes will usually undergo surgical repair.

Remember that bone takes 6-8 weeks to heal properly, but will heal more slowly if conditions are not ideal.  Screws or plates can improve the circumstances and speed healing, but will usually still require 6-8 weeks to return to regular activities.  In otherwords, Jennings will probably not be playing for 6 weeks (at least).
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