Proximal fifth metatarsal fractures

NewsBot · Mar 14, 2023

Conservative versus Surgical Management of Fifth Metatarsal Diaphyseal Fractures: A Retrospective Review
Marc D Jones et al
J Am Podiatr Med Assoc. 2023 Jan-Feb;113(1):20-195

Background: Historically, distal fifth metatarsal diaphyseal fractures have been treated with conservative management, with only limited research evaluating surgical treatment of these fractures. This study was performed to compare surgical versus conservative treatment of distal fifth metatarsal diaphyseal fractures in athletes and nonathletes.

Methods: A retrospective review of 53 patients with surgical or conservative treatment of isolated fifth metatarsal diaphyseal fractures was performed. Data recorded included age, sex, tobacco use, diagnosis of diabetes mellitus, time to clinical union, time to radiographic union, athletic versus nonathletic status, time to return to full activity, surgical fixation method, and complications.

Results: Patients treated surgically had a mean clinical union time of 8.2 weeks, radiographic union time of 13.5 weeks, and return to activity time of 12.9 weeks. Patients treated conservatively had a mean clinical union time of 16.3 weeks, radiographic union time of 25.2 weeks, and return to activity time of 20.7 weeks. Delayed unions and nonunions occurred in 27.0% of patients (10 of 37) treated conservatively and in none in the surgical group.

Conclusions: Surgical treatment significantly decreased time to radiographic union, clinical union, and return to activity by an average of 8 weeks compared with conservative treatment. We suggest that surgical treatment of distal fifth metatarsal fractures is a viable option that may significantly decrease the patient's time to clinical union, radiographic union, and return to activity.
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NewsBot · May 22, 2023

Short-Term Outcomes of Jones Specific Implant vs. Intramedullary Screw and Plate Fixation for Proximal Fifth Metatarsal Fractures
Aman Chopra, BA et al
May 19, 2023

Although intramedullary screw fixation is commonly performed for proximal fifth metatarsal fractures, high rates of nonunion, refracture, and hardware prominence have been reported. The Jones Specific Implant (JSI) is a novel surgical implant which contours to the native curvature of the fifth metatarsal allowing for a more anatomic fixation. The purpose of this study was to compare short-term complication rates and outcomes of patients treated with the JSI to other fixation types such as plates and intramedullary screws. Electronic records were queried for adult patients with proximal fifth metatarsal fractures who underwent primary fixation from 2010 - 2021. All patients were treated by a foot and ankle fellowship-trained surgeon with intramedullary screws, plates, or JSI (Arthrex Inc., Naples, FL). Visual analog scale (VAS) and the American Orthopedic Foot and Ankle Score (AOFAS) were recorded and compared using univariate statistics. Eighty-five patients underwent fixation using intramedullary screw (n=51, 60%), plate (n=22, 25.9%), or JSI (n=12, 14.1%) with a mean follow-up of 11.1±14.6 months. The total cohort demonstrated a significant improvement in VAS pain (p < 0.0001) as well as AOFAS (p < 0.0001) scores. When comparing the cohort treated with JSI and the cohort treated with all other types of fixation, there were no significant differences in postoperative VAS or AOFAS scores. Only three complications, one with JSI, (3.5%) required removal of the symptomatic hardware. The JSI is a novel treatment for proximal fifth metatarsal fractures, with similar early outcomes and complication rates when compared with intramedullary screw and plate fixation.
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Proximal fifth metatarsal fractures

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NewsBot The Admin that posts the news.

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Proximal fifth metatarsal fractures

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Transverse fracture proximal to the fifth metatarsal

'MoAkin' biplanar proximal phalanx closing wedge osteotomy

Proximal influences on plantar pressures

Extensor Digitorum Longus Tendon Insertion in the Proximal Nail Matrix

Proximal Plantar Intrinsic Tendinopathy

Proximal tibial bone graft

Does ‘proximal control’ need a new definition or a paradigm shift in exercise prescription?

Share This Page

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