Comparison of clinical and radiologic outcomes between non-operative and operative treatment in 5th metatarsal base fractures (Zone 1).
The treatment of Zone 1 fractures of the 5th metatarsal base with >2mm of displacement remains controversial. We prospectively analyzed 29 patients with 5th metatarsal base fractures (Zone 1) during 2009-2014. Radiography was performed to assess the degree of fracture gap and metatarsal length. Patients with gaps of 2mm or less were treated conservatively using a short leg cast or splint (Group A), while patients with fracture gap >2mm were randomly assigned to one of two groups. Group B patients were managed with open reduction and internal fixation (ORIF), and Group C patients were placed in a short leg cast only. Visual analog scale (VAS) score and American orthopedic foot and ankle society (AOFAS) score were obtained at the initial consult and at the last follow-up after treatment; change of the 5th metatarsal length was also measured at the initial consult and after complete bony union. Our study demonstrated that radiographic union of all cases was observed with a significant decrease in VAS and AOFAS scores, regardless of the initial fracture gap and type of management. Additionally, there was no difference seen in final VAS scores for patients with longer metatarsals when compared to those in whom the metatarsals were unchanged or shortened.
Department of Orthopedic Surgery, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul 08308, South Korea. Electronic address: red-tank007@hanmail.net.
Tae Hoon
TH
Lee
Department of Orthopedic Surgery, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul 08308, South Korea. Electronic address: yizo@naver.com.
Ji Ho
JH
Lee
Department of Orthopedic Surgery, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul 08308, South Korea. Electronic address: suhwoosman@gmail.com.
Suh Woo
SW
Chay
Department of Orthopedic Surgery, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul 08308, South Korea. Electronic address: jans800@daum.net.
Kyu Sun
KS
Jang
Department of Orthopedic Surgery, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul 08308, South Korea. Electronic address: dakjul@korea.ac.kr.
Hak Jun
HJ
Kim
D000293:Adolescent; D000328:Adult; D000368:Aged; D002370:Casts, Surgical; D005260:Female; D018409:Foot Injuries / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000293:injuries*; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D016896:Treatment Outcome; D016474:Weight-Bearing; D055815:Young Adult
5th Metatarsal base fracture (Zone 1); American orthopedic foot and ankle society (AOFAS) score; Metatarsal length; Visual analogue scale (VAS) score