Patients with an L&B type III fracture mainly were treated surgically, but difference in FAOS score did not reach level of significance. Conservatively treated L&B type II fractures showed an equivalent functional outcome compared to surgical management. Overall, the functional outcome following fractures to the proximal fifth metatarsal bone is satisfactory. The follow-up time was 58 (min: 15 max: 164) months. Operatively treated L&B type III fractures tended to have a better functional score ( p = 0.16). Surgically treated patients with an L&B type II fracture had no statistically significant better functional outcome in comparison to conservative management ( p = 0.89). L&B type I fractures ( n = 13) had a FAOS score of 91 ± 23, L&B type II ( n = 67) presented a score of 91 ± 15 and L&B type III ( n = 23) a score of 93 ± 11. In total, the functional outcomes of 103 patients suffering from fractures to the proximal fifth metatarsal bone were analyzed. For outcome analysis, the nonparametric Mann–Whitney U test was performed and Spearman’s rank correlation coefficient calculated. Data were collected via patient registry, radiographs and a standardized questionnaire (Foot and Ankle Outcome Score = FOAS). The fractures were classified according to Lawrence and Botte (L&B). Only patients with a minimum follow-up of 12 months were included. MethodsĪll patients suffering from single fractures to the proximal fifth metatarsal bone between 20 were enrolled in this retrospective analysis. In the current literature, there still exists controversy regarding treatment recommendations for the different fracture entities. The majority involves the proximal fifth metatarsal bone. The foot and ankle surgeon will determine the type of procedure that is best suited to the individual patient.Metatarsal fractures are common skeletal injuries of the lower extremity in adults. If the injury involves a displaced bone, multiple breaks or has failed to adequately heal, surgery may be required. Bone stimulation, most commonly used for Jones fractures, may be used as part of the treatment or following an inadequate response to immobilization. A pain-free external device is used to speed the healing of some fractures. Crutches may also be needed to avoid placing weight on the injured foot. Depending on the severity of the injury, the foot is kept immobile with a cast, cast boot or stiff-soled shoe. The foot and ankle surgeon may use one of these nonsurgical options for treatment of a fifth metatarsal fracture: Elevation: The foot should be raised slightly above the level of your heart to reduce swelling.Compression: An elastic wrap should be used to control swelling. Use ice for 20 minutes and then wait at least 40 minutes before icing again. Ice: Apply an ice pack to the injured area, placing a thin towel between the ice and the skin.Until you are able to see a foot and ankle surgeon, the RICE method of care should be performed: Because a Jones fracture sometimes does not show up on initial x-rays, additional imaging studies may be needed. The foot will be examined, with the doctor gently pressing on different areas of the foot to determine where there is pain. To arrive at a diagnosis, the surgeon will ask how the injury occurred or when the pain started. Pain, swelling and tenderness on the outside of the footĪnyone who has symptoms of a fifth metatarsal fracture should see a foot and ankle surgeon as soon as possible for proper diagnosis and treatment.Examples include midshaft fractures, which usually result from trauma or twisting, and fractures of the metatarsal head and neck.Īvulsion and Jones fractures have the same signs and symptoms. Other types of fractures can occur in the fifth metatarsal. They are less common and more difficult to treat than avulsion fractures. Jones fractures are caused by overuse, repetitive stress or trauma. A Jones fracture can be either a stress fracture (a tiny hairline break that occurs over time) or an acute (sudden) break. Jones fractures occur in a small area of the fifth metatarsal that receives less blood and is therefore more prone to difficulties in healing. Avulsion fractures are often overlooked when they occur with an ankle sprain. This type of fracture is the result of an injury in which the ankle rolls. In an avulsion fracture, a small piece of bone is pulled off the main portion of the bone by a tendon or ligament. Two types of fractures that often occur in the fifth metatarsal are: The fifth metatarsal is the long bone on the outside of the foot that connects to the little toe. Fractures of the Fifth Metatarsal What Is a Fifth Metatarsal Fracture?įifth metatarsal fractures (breaks) are common foot foot injuries. Please enable Javascript in your browser. Javascript is required to view the content on this page.
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