A prospective nonrandomized study was made of 17 basketball players with fractures of the proximal third of the shaft of the fifth metatarsal. Eight had acute fractures, which were treated with a cast without weight-bearing, and the other nine had stress fractures for which percutaneous compression screwing was initially used. In the first group, union was obtained in four cases in an average of 9 weeks, with resumption of sport by 12 weeks. Three had a good outcome and the fourth was fair. The other four cases, which had not healed after 12 weeks of immobilization, were subsequently treated using compression screws. Resumption of sport was achieved 20-24 weeks after the fracture. Two of these had a good result; in the other two the results were fair. Of the nine patients with stress fractures in which a screw was inserted, all healed between 8 and 14 weeks and returned to sport within 7-12 weeks. Seven had a good result and the other two only fair. There was one intraoperative complication, but no postoperative complications, such as nonunion or refracture, were observed. Even if the non-operative treatment is able to provide a good result, immobilization without weight-bearing does not guarantee healing. In this series, percutaneous screw fixation was able to achieve successful healing in a short period of time. Thus, this procedure seems to be preferable for primary treatment of this lesion in athletes.