![]() Conclusionsįifth metatarsal base fractures gain specific interest when occurring in athletes. The authors intend to study this technique in the clinical setting in the near future. technique is indicated in acute proximal fractures, stress fractures or non-union of metatarsal 5 (Zone 2–3 by Lawrence and Botte) and it resulted feasible and stable during manual stress test. In this article, the cadaveric study and proposed surgical technique are explained and illustrated step by step. On a cadaver, through two mini portals, a full reduction and solid internal fixation with an intramedullary screw and suture cerclage with Fiberwire of a fifth metatarsal base fracture is achieved. (Fifth metatarsal, Extra-portal, Rigid, Innovative) technique. These reports prompted us to look at new materials and a novel technique through fixation with an intramedullary screw combined with a high-resistance suture via the presented F.E.R.I. ![]() 1993 21:720-3.One of the main problems of Kirschner wire fixation of fifth metatarsal base fractures (in combination with a tension band wiring technique) seems to be hardware intolerance and several studies in athletes also report failure after isolated fixation with a screw only. Outpatient percutaneous screw fixation of the acute Jones fracture. Mindrebo N, Shelbourne KD, Van Meter CD, Rettig AC. Analysis of failed surgical management of fractures of the base of the fifth metatarsal distal to the tuberosity: the Jones fracture. Glasgow MT, Naranja J, Glasgow SG, Torg JS. The intraosseous blood supply of the fifth metatarsal: implications for proximal facture healing. Vascular anatomy of the fifth metatarsal. Shereff MJ, Yang QM, Kummer FJ, Frey CC, Greenidge N. Fractures of the base of the fifth metatarsal distal to the tuberosity. Fractures of the base of the fifth metatarsal distal to the tuberosity: a review. Torg JS, Balduini FC, Zelko RR, Pavlov H, Peff TC, Das M. Fracture of the base of the fifth metatarsal by indirect violence. Fractures of the fifth metatarsal: analysis of a fracture registry. Fractures of the proximal fifth metatarsal. Jones' fractures and related fractures of the proximal fifth metatarsal. The surgical treatment of symptomatic nonunions of the proximal (metaphyseal) fifth metatarsal in athletes. Avulsion fracture of the fifth metatarsal: experimental study of pathomechanics. Combined fracture of the base of the fifth metatarsal and the lateral malleolus. Fractures and anatomical variations of the proximal portion of the fifth metatarsal. Type I: nonweight-bearing immobilization for six to eight weeks (may require up to 20 weeks)įorced inversion with ankle in plantar flexionĮlastic wrapping, ankle splints, low-profile walking boot or cast with weight bearing as tolerated (approximately three to six weeks)ĭameron TB. Stress fracture of the proximal metatarsal within 1.5 cm of tuberosity Types II, III: variable healing potential ![]() surgical fixation for active athletes or patients preferring surgical therapy Type II: nonweight-bearing immobilization vs. Type I: nonweight-bearing immobilization for six to eight weeks Laterally directed force on forefoot with ankle in plantar flexion Although most fractures of the proximal portion of the fifth metatarsal respond well to appropriate management, delayed union, muscle atrophy and chronic pain may be long-term complications.Īcute fracture of the proximal metatarsal within 1.5 cm of tuberosity (Jones fracture) All displaced fractures and type III fractures should be managed surgically. Type II fractures may also be treated conservatively or may be managed surgically, depending on patient preference and other factors. Type I fractures are generally treated conservatively with a nonweight-bearing short leg cast for six to eight weeks. Management and prognosis of both acute (Jones fracture) and stress fracture of the fifth metatarsal within 1.5 cm of the tuberosity depend on the type of fracture, based on Torg's classification. Nondisplaced tuberosity fractures are usually treated conservatively, but orthopedic referral is indicated for fractures that are comminuted or displaced, fractures that involve more than 30 percent of the cubo-metatarsal articulation surface and fractures with delayed union. Local bruising, swelling and other injuries may be present. Tuberosity avulsion fractures cause pain and tenderness at the base of the fifth metatarsal and follow forced inversion during plantar flexion of the foot and ankle. Fractures of the proximal portion of the fifth metatarsal may be classified as avulsions of the tuberosity or fractures of the shaft within 1.5 cm of the tuberosity.
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