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The x-rays reveal fractures of both the distal fibula and proximal fifth metatarsal. More specifically, the film on the left shows a transverse proximal fifth metatarsal shaft fracture; this is an unstable injury (Jones facture). Malunion is common, and urgent orthopedic follow-up is indicated.

Fractures through the tuberosity of the proximal fifth metatarsal that do not involve the shaft are stable fractures (pseudo-Jones) and can be treated with a post-op shoe.

For this patient, a cast splint was applied, with instructions to follow up with an orthopedist.
Case presented by Nahum Kovalski, BSc, MDCM.

42-year-old woman in considerable ankle pain

Nahum Kovalski, BSc, MDCM

Clinical Researcher at TEREM Emergency Services
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