Also, the shaft may be angulated laterally, making the fifth metatarsal head more prominent. Consequently, constricting shoes are the main source of discomfort. With continuous pressure over the prominent fifth metatarsal, a bursa can develop as a result of chronic irritation to the area. Over time, this bursa can develop into an ulceration. In patients with diabetes, advanced Charcot-Marie-Tooth disease, or certain types of spinal dysraphism with poor sensibility, this complication can result in loss of the entire fifth ray or even the foot.
