Is a cast necessary for a double fifth metatarsal foot fracture?

Yes: Immobilization is important if the bone is fractured in two areas, so casts or walking boots (cam walkers), and even crutches might be surgery. If the fracture is in alignment and without gapping of the fracture ends, it should heal. Surgery is also an option in healing this type of injury.

Depends: Certainly acceptable. Some docs nowadays dispense cam walker boots.

May be a good option: Cast are an excellent way to immobilize a fracture.