Fractures of the fifth metatarsal; diagnosis and treatment.
Of all foot fractures the fifth metatarsal fracture is the most common. A complete clinical and radiological assessment is required to select the best treatment option. Nondisplaced tuberosity avulsion fractures can be treated non-operatively. Surgical treatment is indicated when the fracture is displaced more than 2mm or when more than 30% of the cubometatarsal joint is involved. Non or minimally displaced shaft fractures can be treated non-operatively. If the dislocation is more than 3-4mm or the angulation is more than 10 degrees, percutaneous K-wires, plate or screw fixation is indicated. The Jones fracture is known for prolonged healing time and non-union. The indication for surgical treatment of Jones' fractures depends on activity level and Torg classification: type I fractures are treated non-operatively. Type II fractures can be treated non-operatively or operatively, depending on patient activity level. Type III fractures have more complications and should be treated operatively. Several operation techniques have been described.
Zwitser
E W
EW
Department of Trauma Surgery, Rode Kruis Ziekenhuis, Vondellaan 13, 1942 LE Beverwijk, The Netherlands. ewzwits@hotmail.com
Breederveld
R S
RS
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology*; D050723:Fractures, Bone / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000293:injuries*; D008875:Middle Aged; D011859:Radiography; D020127:Recovery of Function; D055815:Young Adult