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This becomes a bone spur. When the bone spur grows out of one of the joints on the top of the midfoot, it's called a tarsal boss. A bone spur on the inside or outside any of the toes is usually referred to as a toe spur. Any factor that creates too much friction within the foot can lead to a tarsal boss or toe spur.
In young athletes, operative screw fixation is the treatment of choice. The 5th metatarsal is divided into 3 zones. Zone I is an avulsion fracture, zone II is described as a Jones fracture and zone III is proximal diaphyseal fracture (Illustration A). Nonunions are more common with fractures in zones II and III. Lehman et al reviewed fractures of the base of the fifth metatarsal.