Locking compression plate distal ulna hook plate as alternative fixation for fifth metatarsal base fracture.
Intramedullary screw fixation has been the most common treatment for fifth metatarsal base fractures. However, screw application will not achieve accurate reduction in fractures with small fragments, osteoporotic bone, or Lawrence zone 1 fractures. Because of the similar anatomic architecture between the distal ulna and the fifth metatarsal base, the purpose of the present study was to assess the results of a locking compression plate distal ulna hook plate in stabilizing displaced zone 1 or 2 fifth metatarsal base fractures. A total of 19 patients with Lawrence zone 1 (n = 12) or 2 (n = 7) fractures of the fifth metatarsal base were treated surgically with a locking compression plate distal ulna hook plate. The patients were evaluated clinically and radiographically, and the functional outcomes were graded using the American Orthopaedic Foot and Ankle Society midfoot scoring system. Radiographic bony union was obtained in all patients, at an average of 7.4 weeks. The mean American Orthopaedic Foot and Ankle Society midfoot score improved from 26 (range 0 to 45) points preoperatively to 94 (range 72 to 100) points at the final follow-up visit. Three patients developed post-traumatic cubometatarsal arthrosis, and 1 patient developed sural nerve neurapraxia. In our experience, the distal ulna hook plate achieved a high rate of bony consolidation and anatomically suitable fixation in zone 1 or 2 fifth metatarsal base fractures. We suggest that the locking compression plate distal ulna hook plate should be considered as an alternative treatment of multifragmentary, osteoporotic, and tuberosity avulsion (zone 1) fifth metatarsal base fractures.
Professor, Department of Orthopedic Surgery, Eulji University College of Medicine, Daejeon, Korea. Electronic address: sklee@eulji.ac.kr.
Sang Ki
SK
Lee
Doctor, Department of Orthopedic Surgery, Eulji University College of Medicine, Daejeon, Korea.
Ju Sang
JS
Park
Professor, Department of Orthopedic Surgery, Eulji University College of Medicine, Daejeon, Korea.
Won Sik
WS
Choy
D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D005260:Female; D018409:Foot Injuries / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000293:injuries / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
Jones fracture; LCP; foot; post-traumatic arthrosis; screw fixation; trauma