Operative versus nonoperative treatment of type 1 fifth metatarsal fracture in nonprofessional athletes

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Abstract

Introduction
Treatment approach to fifth metatarsal fractures (FMFs) in athletes has been largely influenced by the eagerness to reduce the time away from sport and ensure healing, which provided the drive for primary fixation as the accepted standard of treatment for the athlete.
Patients and methods
The current study was conducted as a prospective cohort study. A total of 24 patients who had FMF type 1 (avulsion of the tuberosity) were divided into two groups. Group 1 included 12 patients who underwent open reduction and internal fixation using a single screw, whereas group 2 included 12 patients who underwent nonoperative treatment in the form of below-knee cast.
Results
The average American Orthopaedic Foot and Ankle Society score for group 1 was 98.3, whereas for group 2 was 93.9 (=0.03). The average visual analog scale for pain in group 1 was 0.5, whereas in group 2 was 1.1 (=0.13). The average fracture union time in group 1 was 3.8 weeks, whereas in group 2 was 7.5 weeks (=0.00001). The average time for return to sports in group 1 was 7.1 weeks, whereas in group 2 was 8.7 weeks (=0.00023).
Conclusion
Operative treatment of FMF type 1 showed significantly superior American Orthopaedic Foot and Ankle Society scores, less fracture healing time, and less time required to return to recreational sports over those who were treated conservatively; however, there was no difference in pain scores.

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The Egyptian Orthopaedic Journal
Volume 51, Issue 4
October 2016
Pages 319-322

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