The Dameron-Lawrence-Botte classification, or Lawrence-Botte classification, is a commonly used system for proximal fifth metatarsal fractures as it has management implications 3.
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Classification
Under this system, proximal fifth metatarsal fractures are categorized into one of three anatomic zones of involvement:
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zone 1: tuberosity (styloid process) avulsion fracture
involving proximal tuberosity, starting from the lateral cortex
with or without articular involvement of the metatarsocuboid joint
can be treated non-operatively 3
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zone 2: Jones fracture
involving distal tuberosity and metaphyseal-diaphyseal junction, extending to the 4th-5th intermetatarsal articulation
without involvement of the tarsometatarsal joint
can be treated initially non-operatively in the non-athletic population and operatively in the athletic population 3
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zone 3: diaphyseal stress fracture
proximal 1.5 cm of the diaphysis, distal to the 4th-5th intermetatarsal articulation
can be treated initially non-operatively in the non-athletic population and operatively in the athletic population 3
History and etymology
The American orthopedic surgeons Steven J Lawrence and Michael J Botte described the classification in 1993. Then they were numbered by another American orthopedic surgeon, Thomas B Dameron, Jr, in a subsequent publication 1,2.
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