title: Utility of follow-up radiographs in conservatively managed acute fifth metatarsal fractures.
abstract: Fifth metatarsal fractures are the most common fracture of the foot, with the majority being managed conservatively. A variety of treatment methods are described in the literature. Follow-up radiographs are taken to identify fracture displacement, and subsequently to assess for bony union throughout treatment. We assessed the utility of serial radiographic assessment in management of these fractures. Clinical notes and radiographs of 79 patients with fifth metatarsal fractures were analysed retrospectively. Serial radiographs were studied to identify displacement and the last X-ray was reviewed for evidence of fracture union. 96% of fractures were managed conservatively. 29% showed radiological healing at last clinic visit, the rest being discharged as were considered clinically healed. Similar fracture types were managed differently. 3 fractures were surgically treated after failed conservative management. 1 fracture showed displacement from initial radiographs, and was successfully managed conservatively. Without clear guidelines, these injuries are managed differently from a radiological perspective. Follow-up radiographs taken before 6-8 weeks do not appear to alter patient management. Based on the current study we present our recommendations for radiographic assessment of acute fifth metatarsal fractures.
authors: Aberdeen Royal Infirmary and Woodend Hospital, Aberdeen, UK. Electronic address: manojnagar1980@gmail.com.
authors: Manoj
authors: M
authors: Nagar
authors: Aberdeen Royal Infirmary and Woodend Hospital, Aberdeen, UK. Electronic address: n.forrest@nhs.net.
authors: Neil
authors: N
authors: Forrest
authors: University of Aberdeen, Aberdeen, UK. Electronic address: campbellmaceachern@nhs.net.
authors: Campbell F
authors: CF
authors: Maceachern
mesh_terms: D002370:Casts, Surgical; D005500:Follow-Up Studies; D061826:Foot Orthoses; D005592:Fracture Fixation; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D008682:Metatarsal Bones / Q000293:injuries*; D011859:Radiography; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D016474:Weight-Bearing
keywords: Acute fracture; Conservative treatment; Fifth metatarsal; Fracture displacement; Fracture healing; Metatarsal fracture; Radiography