Review: Review ArticleStress Fractures of the Fifth Metatarsal in AthletesPatel, Karan A. MD; Christopher, Zachary K. MD; Hubbard, Christopher E. MD; O'Malley, Martin J. MDAuthor Information From the Mayo Clinic Arizona, Phoenix, AZ (Patel, Christopher), Chilton Medical Center, Pompton Plains, NJ (Hubbard), and the Hospital for Special Surgery (O'Malley), New York, NY. None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Patel, Christopher, Hubbard, and O'Malley. Journal of the American Academy of Orthopaedic Surgeons: June 15, 2021 - Volume 29 - Issue 12 - p 507-517 doi: 10.5435/JAAOS-D-20-01060 Metrics Abstract Stress fractures of the fifth metatarsal (zones 2 and 3) remain a challenging clinical problem. It has been well established that nonsurgical treatment has unacceptably high nonunion and refracture rates. Surgical fixation remains the treatment of choice in the athletic cohort, and intramedullary screw fixation with a solid screw has been established as the most predictable means of achieving a successful outcome. Recently, the use of a plantar plate has also been advocated as has been shown in some studies to be more biomechanically advantageous. The use of bone grafting at the primary surgery and morphology and screw type are also important decisions to be made when treating these patients. This review will discuss our management of both primary fractures and refractures of the fifth metatarsal in athletes. Copyright 2021 by the American Academy of Orthopaedic Surgeons.