Functional treatment of acute metatarsal fractures: a prospective randomised comparison of management in a cast versus elasticated support bandage

Symptomatic treatment or cast immobilisation for avulsion fractures of the base of the fifth metatarsal

“…A number of non-operative forms of treatment have been studied which range from elasticated bandaging and wearing a hard-soled shoe through to immobilisation in a cast, focused rigidity casting or a walking boot. 2,[4][5][6][7][8][9][10][11][12][13][14] Few authors recommend internal fixation. 3,15,16 Although some authors draw a distinction between the treatment of displaced and undisplaced fractures, others have noted no clear effect of the degree of comminution, the amount of displacement and the propagation of fracture into the fifth tarsometatarsal joint on the outcome of non-operative management.…”

“…3,9,17 The limitations of previous studies, which compare non-operative treatments, include a lack of a comparative group; the inclusion of a heterogeneous group of metatarsal fractures; prospective randomised studies without power analyses and the use of non-validated outcome measures. [5][6][7]9 The aim of this study was to carry out a prospective, randomised, non-inferiority, controlled study to compare symptomatic treatment in a double-layered elasticated bandage with immobilisation in a below-knee cast. The rationale for this design of study is that it may offer an advantage in terms of cost, availability and outcome compared to a reference form of treatment.…”

Early radiographic and clinical outcomes of minimally displaced proximal fifth metatarsal fractures: cast vs functional bandage

“…In contrast, Lawrence and Botte 12 claimed that fractures of Zone-1 have excellent healing potential, thus they should be treated symptomatically in any case. Several Authors even recommended functional treatment for Type-1 and -2 fractures indifferently, both non-displaced and displaced [29][30][31][32] , without considering the impact of fracture dislocation, number of fragments, or involvement of the cuboid-metatarsal joint.…”

Likelihood of Surgery in Isolated Pediatric Fifth Metatarsal Fractures

“…1 Although Jones was the first to describe the fracture (and ultimately gave his name), 10 its exact location has been the topic of some debate, with some authors noting it as the proximal diaphysis 2 and others noting it as the metaphyseal-diaphyseal junction. 2,3,9,[11][12][13][14][15][16][17][18][19][20] However, the proximal metaphyseal-diaphyseal junction and proximal diaphysis remains the area of difficulty in treatment of fractures to this bone due to a watershed region of poor perfusion in this location, 4,9 and this is true both in adults and adolescents. Some authors have noted that this differentiation is merely semantics, as both areas can be troublesome with healing 2-4 ; however, identifying the zone where healing is difficult is still crucial and often difficult in the clinical setting.…”