Fifth metatarsal stress fractures, especially the Jones fracture at zone two, are notorious for delayed healing due to a watershed blood supply. Understanding the zone classification guides whether conservative casting or intramedullary screw fixation is appropriate. This video breaks down the anatomy, epidemiology, and management principles you need to know. ⏱ Chapters 0:00 Intro 0:31 Why The Fifth Breaks 1:42 Zone 2 On The Oblique Film — Name The Zone… 2:59 Reading The Film 3:42 Torg Staging — Chronicity Decides Healing 4:45 The Treatment Ladder 5:40 High And Lateral — The Screw That Fills The… 6:55 The Screw Tip Is A New Stress Riser 7:32 Back To Play 9:15 Cavus Or Flat — The Lateral Column Still… 9:56 Recap & sources This video explains why proximal fifth metatarsal fractures heal poorly, detailing the Lawrence‑Botte zone system, the watershed blood supply at the metaphyseal‑diaphyseal junction, and how Torg classification predicts healing potential. It contrasts conservative management of zone 1 avulsions with surgical indications for zones 2 and 3, and highlights return‑to‑sport timelines and key radiographic signs. 🦴 IN THIS VIDEO YOU'LL LEARN • Identify the three Lawrence‑Botte zones of the proximal fifth metatarsal • Differentiate a true Jones fracture (zone 2) from a tuberosity avulsion (zone 1) • Explain why zone 2 is a watershed area with poor retrograde blood flow • Recognise the radiographic features of Torg type I, II and III fractures • Determine when conservative non‑weight‑bearing casting is appropriate • Select patients who benefit from intramedullary screw fixation • Describe the role of bone grafting in chronic non‑unions • Outline return‑to‑sport expectations after surgical versus conservative treatment • Spot common pitfalls such as missing a zone 2 fracture on oblique views 📌 KEY TAKEAWAYS ✔️ Zone 1 avulsions heal reliably with conservative care ✔️ Zone 2 Jones fractures have a 25‑50 % non‑union rate without surgery ✔️ Zone 3 stress fractures carry the highest non‑union risk and often need grafting ✔️ Intramedullary screw fixation reduces healing time to 6‑8 weeks in athletes ✔️ Naming the zone before treatment prevents inappropriate management 👩⚕️ WHO THIS IS FOR This content is suited for orthopaedic trainees, medical students, clinicians managing foot injuries, and interested patients who want a clear, evidence‑based understanding of fifth metatarsal stress fractures and their treatment options. 📚 RELATED TOPICS: Lisfranc injury mechanisms and management · Metatarsalgia and forefoot overload syndromes · Peroneus brevis tendon pathology and avulsion injuries · Foot stress fractures in runners and dancers · Biomechanical effects of pes planus and pes cavus on lateral column loading · Techniques for intramedullary screw fixation of the fifth metatarsal 🔗 More free orthopaedic teaching at Orthovellum.com — subscribe for weekly videos. 🎨 CREDITS • Original Orthovellum production. ⚠️ DISCLAIMER: Educational only — not individual medical advice. Always consult a qualified clinician for diagnosis and treatment. #orthopaedics #footfracture #jonesfracture #fifthmetatarsal #stressfracture #watersupply #screwfixation #sportsmedicine #orthotraining #footanatomy #fracturehealing #avulsionfracture #bonegraft #returntosport #clinicaleducation