The outcome of proximal fifth metatarsal fractures: redefining treatment strategies

Monteban, P; Berg, J. van den; Hees, J. Van; Nijs, Stefaan; Hoekstra, Harm

doi:10.1007/s00068-017-0863-x

Cited by 14 publications

(26 citation statements)

References 21 publications

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“…The authors are aware of only 2 studies providing a follow-up of more than 2 years: one with 2.2 years 19 and the other with 2.7 years. 15 Therefore, this study provides the longest follow-up reporting objective measures.…”

Section: Discussionmentioning

confidence: 99%

“…For type II fractures, most authors recommend either nonweightbearing and immobilization for 6 to 8 weeks or operative management. 8,16,19,20 Few have suggested functional treatment. 6,9,15 Without much question, a consistent issue with these injuries is simply one of nomenclature, as these fractures are called by many names, some of which are not always clear in terms of what they represent.…”

Section: Discussionmentioning

confidence: 99%

“…33 These recommendations are not based on evidence but rather reflect single authors’ opinions. 4,11,16,19,34 Few studies have actually analyzed the influence of those fracture characteristics on patient-reported outcome. 3,9,29 Unfortunately, these studies presented only short-term follow-up (20 weeks to 2 years).…”

mentioning

confidence: 99%

“…2,3,8,22 While there is strong evidence supporting operative treatment for type III fractures, 18 recommendations for type II fractures vary from immobilization and nonweightbearing to operative treatment. 8,16,19,20 Some authors, on the other hand, have hypothesized that functional treatment can lead to favorable results. 6,9,15 Again, mid- to long-term results are missing.…”

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confidence: 99%

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Results of Functional Treatment of Epi-Metaphyseal Fractures of the Base of the Fifth Metatarsal

et al. 2020

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Background: Fractures of the fifth metatarsal base (5th MT) are common foot injuries, but their treatment remains a subject of debate. The aim was to assess the midterm outcome of functionally treated epi-metaphyseal fractures (Lawrence and Botte types I and II) of the 5th MT. Methods: This study was a longitudinal retrospective database study with prospective follow-up. Included were all patients with an acute, isolated fracture to the 5th MT base (types I and II). All patients were treated functionally: weightbearing as tolerated without immobilization. Fracture types and fracture characteristics (displacement <2 mm/>2 mm, articular involvement, number of fragments) were assessed retrospectively. Patient-reported outcome measures (PROMs) including the visual analog scale for foot and ankle (VAS FA) and the quality-of-life score (QoL) SF-12 were collected prospectively at 2- and 5-year follow-up. Out of 95 patients, 43 patients (45%) were included with a median follow-up of 5.7 (1.5) years. Results: For both the VAS FA and SF-12, excellent scores were observed. For 30 patients (77%), longitudinal 2- and 5-year follow-up was available. No significant longitudinal changes could be observed for the VAS FA and SF-12. For both time points, neither fracture type nor characteristics significantly influenced any outcome parameter assessed. Conclusion: Functional treatment by full weightbearing and free range of motion led to excellent 5-year results for both type I and II fractures. Neither fracture location nor characteristics had a significant influence on the 5-year PROMs. Level of Evidence: Level III, comparative study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Results of Functional Treatment of Epi-Metaphyseal Fractures of the Base of the Fifth Metatarsal

et al. 2020

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“…According to P. Monteban et al [26] for the treatment strategies of pseudo-Jones metatarsal fracture can safely be treated non-operatively (full casting, backslab or bandaging) with good patient-reported outcome, less complications and re-interventions, lower healthcare cost, and without increased economic burden. Surgery can be reserved for those with delayed union after failed conservative treatment [26, 27]. There is a paucity of literature regarding non-operative treatment of Pseudo-Jones fractures of the fifth metatarsal base.…”

Section: Discussionmentioning

confidence: 99%

Comparative outcomes of foot cast and short leg cast in pseudo‐Jones avulsion fracture: a single blinded randomized controlled trial

Piyapittayanun

Mutthakalin

Arirachakaran

et al. 2019

Journal of Foot and Ankle Research

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Background Fractures of the metatarsal bones account for 35% of all foot fractures. Conservative management of fractures proximal to the metaphyseal-diaphyseal junction of the fifth metatarsal bone (pseudo-Jones) is by protected weight bearing. The methods of protected weight bearing include short-leg casting and splinting (boot cast, Jones’s bandage and elastic bandage). However, currently there is no consensus as to which method is the most suitable. Method We have conducted a randomized controlled trial to compare outcomes of foot casting (FC) and short leg casting (SLC) to assess pain, function and complication outcomes for the treatment of pseudo-jones metatarsal fractures. This single-center, single blind,randomized controlled trial was conducted between 1 June 2016–1 July 2018 at Police General Hospital, Bangkok, Thailand. Result A total of 72 pseudo-jones metatarsal fracture participants were randomly allocated to treatment by foot cast or short leg cast. The primary outcomes were pain VAS, AOFAS and complications measured at 2, 4, 6 and 8 weeks after receiving the treatment. Seventy-two patients (36 paticipants per group) were enrolled to receive either FC or SLC. The mean VAS measured at baseline, 2 weeks, 4 weeks, 6 weeks and 8 weeks were 7.36, 1.97, 0.58, 0.17 and 0.08 respectively in the FC group; and 6.09, 2.91, 1.23, 0.37 and 0.11 respectively in the SLC group. The mean AOFAS at baseline, 2, 4, 6 and 8 weeks were 33.60, 68.22, 82.72, 91.75 and 98.11 respectively in the FC group; and 32.60, 60.20, 70.20, 92.24 and 99.13 in the SLC group. The estimated mean difference of pain VAS and AOFAS at 2 weeks and 4 weeks were − 0.94 (95% CI: − 1.53, − 0.34), − 0.65 (95%CI: − 1.24, − 0.05), 8.02 (95%CI: 3.74, 12.10) and 12.52 (95%CI: 8.27, 16.78), which were statistically significantly better in the FC groups when compared to the SLC groups. However, there were no statistically significant difference between the two groups at 6 and 8 weeks. Conclusion This study demonstrated that the application of foot casting can improve pain VAS and AOFAS function at 2 and 4 weeks in the treatment of pseudo-jones metatarsal fractures when compared to short leg casting. However, at 6 and 8 weeks, there were no statistically significantly different between the two groups.

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Jones Fractures

Doan¹,

Hunt²

2019

Sports Injuries of the Foot and Ankle

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The outcome of proximal fifth metatarsal fractures: redefining treatment strategies

Abstract: 3.

Cited by 14 publications

References 21 publications

Results of Functional Treatment of Epi-Metaphyseal Fractures of the Base of the Fifth Metatarsal

Results of Functional Treatment of Epi-Metaphyseal Fractures of the Base of the Fifth Metatarsal

Comparative outcomes of foot cast and short leg cast in pseudo‐Jones avulsion fracture: a single blinded randomized controlled trial

Jones Fractures

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