Treatment of Proximal Fifth Metatarsal Fractures and Refractures With Plantar Plating in Elite Athletes

Bernstein, Derek T.; Mitchell, Ronald J.; McCulloch, Patrick C.; Harris, Joshua D.; Varner, Kevin E.

doi:10.1177/1071100718791835

Cited by 31 publications

(53 citation statements)

References 24 publications

(44 reference statements)

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“…All the patients were able to return to sport at the same level of competition after plantar plating. 1 Seidenstricker et al 28 stated that all 4 patients were able to return to full activity after plate fixation though they did not mention the period of time to their return. In this study, all patients were allowed running activity when they were clinically asymptomatic and had progressed to union, as indicated by plain radiography and confirmed by CT.…”

Section: Discussionmentioning

confidence: 99%

“…Torsional instability and plantar-lateral gapping are resisted by applying a compression plate to the tension side of the fifth metatarsal bone, eliminating causes for failure. 22 Bernstein et al 1 stated that proper positioning of the plate directly resists tensile forces and subsequent gap formation. Plates can be contoured to the metatarsal bone, which obviates concerns regarding the differential diameter of the intramedullary canal proximally vs distally.…”

Section: Discussionmentioning

confidence: 99%

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Operative Results of Plantar Plating for Fifth Metatarsal Stress Fracture

et al. 2020

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Background: The treatment of fifth metatarsal stress fractures can be challenging. Various operative fixation methods have been reported for fracture management. Among them, intramedullary screw fixation has become increasingly popular. However, recent reports have described failures after screw fixation in athletes. The aim of this study was to determine the rates of clinical and radiographic healing, time to return to sport, and complications of elite athletes with proximal fifth metatarsal fractures treated with plantar plating. Methods: Thirty-eight athletes with fifth metatarsal stress fractures treated using a plantar plating technique in 3 hospitals from 2013 to 2018 were evaluated retrospectively. Demographic data, radiographic evaluation, and the time until union and return to sports activities were collected and analyzed. A total of 38 patients underwent the plantar plating for a fifth metatarsal stress fracture with a mean follow-up of 23 (range, 12-49) months. Results: The mean time to the radiologic union, as determined by plain radiography, was 9.3 (range, 8-16) weeks. Although there were no nonunions or delayed unions during follow-up, 4 refractures developed (10.5%). All but 1 patient were able to return to their previous levels of sporting activity at 22.2 ± 4.5 (range, 12-40) weeks. Conclusion: With a minimum of 1-year follow-up, the described plantar plating technique could be an alternative method for the operative treatment of fifth metatarsal stress fractures without nonunion problems. Level of Evidence: Level IV, case series.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Operative Results of Plantar Plating for Fifth Metatarsal Stress Fracture

et al. 2020

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“…Segundo estudo cadavérico de Duplantier et al (12) , esse método de fixação apresentou valor mais elevado de ciclos para falha, força de pico maior para falha e menor gap imediatamente antes da falha do implante, quando comparado aos obtidos pelo parafuso intramedular. Bernstein et al (11) também mostraram resultados promissores no tratamento de 08 atletas de elite com fraturas primárias ou refraturas da base do quinto metatarso. Não houve nenhuma complicação de ferida, retardo de consolidação, pseudoartrose, refratura, falha do implante ou queixas sobre material proeminente, com consolidação clínica ocorrendo em média 6,5 semanas após a cirurgia, e com retorno ao esporte no mesmo desempenho anterior à lesão.…”

Section: Discussionunclassified

“…Das formas de tratamento cirúrgico possíveis destaca--se a fixação com parafuso intramedular, opção mais aceita atualmente para as fraturas das zonas II e III em atletas (9,10) , podendo estar associada ou não à utilização de enxerto ósseo autólogo, considerando-se a vascularização mais frágil dessas fraturas e o tempo decorrido da lesão até o tratamento. Tem-se mais recentemente dado destaque à utilização de placas plantares para o tratamento dessas lesões (11,12) . O objetivo desse trabalho é avaliar o resultado funcional de jogadores de futebol profissionais submetidos ao tratamento cirúrgico das fraturas da base do quinto metatarso nas zonas II e III de Dameron com parafuso intramedular, com ou sem enxerto ósseo.…”

Section: Introductionunclassified

Mid-term follow-up after surgical treatment of fifth metatarsal base fractures in professional soccer players

et al. 2019

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Objective: Fifth metatarsal fractures occur mainly in young athletes, with an estimated incidence of 1.8 per 1,000 people a year. The objective of this study was to evaluate the functional outcome of professional soccer players subjected to surgical treatment of fifth metatarsal base fractures. Methods: A total of 34 soccer players who underwent surgery from July 2001 to June 2016 were evaluated. All participants were evaluated by the American Orthopedic Foot and Ankle Score (AOFAS) and visual analogue scale (VAS) score before and after surgery, with a mean follow-up of 23 months. The need for grafting relative to time to surgery, time to fracture consolidation and Torg classification and graft use relative to return to sport were valuated. Results: There were 10 forwards, 7 offensive midfielders, 6 fullbacks, 5 center midfielders, 3 defenders, 2 goalkeepers and 1 defensive midfielder, with a mean age of 19 years. The mean pre- and postoperative AOFAS was 42 and 99 points whereas the mean VAS score was 6 and 0, respectively. The longer the time to surgery, the greater was the need for grafting (p=0.011). The time to return to sport was not influenced by the time to surgery, time to consolidation, Torg classification or graft use. Conclusion: The surgical treatment of fifth metatarsal base fractures in professional soccer players showed good clinical results. The return to activities after surgery is not influenced by the time to surgery, time to consolidation, Torg classification or grafting. Level of Evidence IV; Therapeutic Studies; Case Series.

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“…These fractures can lead to serious incidence rate, especially in athletes, the time of competition is obviously shortened, and refracture, sometimes it cannot resume sport. [ 3 – 5 ]…”

Section: Introductionmentioning

confidence: 99%

Surgical versus conservative management of fifth metatarsal fractures in adults

Li²,

Xie³

et al. 2020

Medicine

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Background: At present, the treatment of base fractures of the fifth metatarsal, especially the area I fractures, is still a controversial topic. The objective of our work was to assess the radiological and clinical outcomes of displaced avulsion fractures of the fifth metatarsal base after treated with conservative treatment or intramedullary screw. Methods: All of the fifth metatarsal fractures patients underwent surgery by the senior authors in our hospital from January 2017 to December 2019 were reviewed. Institutional Review Board in the Subsidiary Hospital of Guizhou Medical University approved this study. Patients with the following conditions can be included: the displaced avulsion fracture of fifth metatarsal base; aged 18 to 40 years; a completed medical history; the patients were followed up for at least 6 months. Patients with the following conditions will be excluded: follow-up less than 6 months; open fracture; pathological fracture; osteoporotic fracture; patients have the history of ankle or foot surgery. Radiographs were taken at 1, 3, 6 and 12 months in outpatient follow-up. The following outcomes were assessed in the follow-up: functional outcomes, the score of patient satisfaction, as well as the motion range, and complications. All the statistical analyses were implemented via applying the software of SPSS Version 12 (SPSS Inc, Chicago, IL). Results: We hypothesized that there was no remarkable difference between two groups in the outcomes after operation. Trial registration: This study protocol was registered in Research Registry (researchregistry6024).

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Treatment of Proximal Fifth Metatarsal Fractures and Refractures With Plantar Plating in Elite Athletes

Abstract: Level IV, case series.

Cited by 31 publications

References 24 publications

Operative Results of Plantar Plating for Fifth Metatarsal Stress Fracture

Operative Results of Plantar Plating for Fifth Metatarsal Stress Fracture

Mid-term follow-up after surgical treatment of fifth metatarsal base fractures in professional soccer players

Surgical versus conservative management of fifth metatarsal fractures in adults

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