The Intraosseous and Extraosseous Vascular Supply of the Fifth Metatarsal

Abstract

Osteotomies placed within the proximal 40 mm of the bone carry a risk of disrupting the nutrient artery, resulting in possible nonunion.

Plantar Plating for the Treatment of Proximal Fifth Metatarsal Fractures in Elite Athletes

“…Careful open dissection limits risk of injury to the sural nerve. 4,13 To optimize healing, the addition of cancellous autograft from various donor sites has been described. 2,3 Use of calcaneus autograft allowed biologic optimization while using a single operative field.…”

“…1 Demands on elite athletes often result in fractures of this region (Figure 1), which faces a challenging avascular healing environment. [2][3][4][5] The benefits of surgical treatment for acute and stress-related proximal fifth metatarsal fractures are well established. 2,3,5,6 Surgical treatment results in shorter time to union and reduced nonunion rates.…”

A Morphometric Study on the Nutrient Foramen of Metatarsal Bones in the Jharkhand Population

“…Topography of the nutrient artery in the fifth metatarsal bone is important while planning a corrective osteotomy for a bunionette deformity. This would allow the most proximal osteotomy possible without interrupting the nutrient arterial supply (McKeon et al 2013) [21] . They described the nutrient artery and studied the topography of the nutrient foramen of the fifth metatarsal bone.…”

Jones Fractures

“…The blood supply comes from the metaphyseal arteries at the base of the fifth metatarsal and a nutrient artery that enters at the proximal diaphysis and travels proximally 3 . A cadaveric study demonstrated that an osteotomy created in the proximal 40 mm of the fifth metatarsal violated the nutrient artery 14 . Therefore, zone-II and III fractures occurring within this region of the metatarsal have poor healing potential.…”