Dameron-Lawrence-Botte classification of proximal 5th metatarsal fractures

Last revised by Dr Francis Deng on 22 Jan 2020

The Dameron-Lawrence-Botte classification, or Lawrence-Botte classification, is a commonly used nomenclature for proximal fifth metatarsal fractures, which are categorized into one of three anatomic zones of involvement:

  • zone 1: ​tuberosity (styloid process) avulsion fracture
    • involving proximal tuberosity, starting from the lateral cortex
    • with or without articular involvement of the metatarsocuboid joint
  • zone 2Jones fracture
    • involving distal tuberosity and metaphyseal-diaphyseal junction, extending to the 4th-5th intermetatarsal articulation
    • without involvement of tarsometatarsal joint
  • zone 3diaphyseal stress fracture
    • proximal 1.5 cm of the diaphysis, distal to the 4th-5th intermetatarsal articulation

History and etymology

The classification was described by the American orthopedic surgeons Steven J Lawrence and Michael J Botte in 1993 and then numbered by another American orthopedic surgeon, Thomas B Dameron, Jr, in a subsequent publication 1,2.

See also

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Cases and figures

  • Figure 1: fractures of the proximal 5th metatarsal
    Drag here to reorder.
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