Introduction: Proximal fifth metatarsal fractures are common. When using the Lawrence and Botte Classification for these injuries, they are classified as type 1, 2, and 3. Identifying the zone of injury is crucial to guide treatment. The authors hypothesize that interand intra-observer reliability of these fractures is low. Methods: Anteroposterior (AP), lateral, and oblique x-rays of 60 patients with isolated fifth metatarsal base fractures were reviewed. Five physicians evaluated the radiographs and classified the fractures as type 1,2, or 3. Each of the three radiographic views were examined separately. Results were then analyzed for inter- and intra-observer reliability. Results: Sixty x-rays of each of the three views were reviewed by five observers, with a total of 900 observations. Observer 1 classified all three radiographs the same at a rate of 41.67% (25/60) with Fleiss’ kappa (k) 0.31; for observers 2 through 5, their rate was 63.33 % (38/60), 0.573 (k), 68.33% (41/60), 0.55 (k), 58.33% (35/60), 0.55 (k), and 36.67% (22/60), 0.31 (k), respectively. For the AP view, inter-observer reliability showed 56.67% (34/60) agreement with 0.64 (k). For the oblique and lateral views, rates were 45% (27/60), 0.51 (k), and 35% (21/60), 0.44 (k), respectively. Overall, inter-observer reliability was 16.67%. Conclusion: There is poor inter-observer and intraobserver reliability in the current proximal 5th metatarsal classification. This study highlights the importance of using all radiographic views and clinical history for the correct treatment. Future study shou

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