Endoscopic Management of Nonunion of the Tuberosity of the Fifth Metatarsal

Tuberosity avulsion fractures of the fifth metatarsal are common and the lateral band of the plantar aponeurosis as the structure more likely to cause these fractures. Most tuberosity avulsion fractures heal by 8 weeks with conservative treatment. Symptomatic nonunion can occasionally occur. Internal fixation with or without bone graft is the treatment of choice for painful nonunion if conservative treatment fails. The purpose of this Technical Note is to describe the details of endoscopic management of nonunion of the tuberosity of the fifth metatarsal without diastasis. This includes endoscopic release of the nonunion site, debridement of the fibrous tissue, microfracture of the sclerotic bone surfaces, and percutaneous screw fixation.