12/1/2023 0 Comments Proximal fifth metatarsal fractureThe majority of these have been shown to heal quickly and uneventfully with time under conservative treatment, while others have developed painful non-unions. In 1902, Sir Robert Jones proved for the first time that sprains of the foot can result in fractures of the base of MT5 ( 2). Of 372 isolated metatarsal fractures, 30% involved the base of MT5 (Figure 1). For the present review, the authors conducted a retrospective analysis of their own patient population over a period of two years (eFlowchart). 6.7 per 100 000 persons ( 1), with the base of the fifth metatarsal bone (MT5) being most commonly involved. Metatarsal fractures are among the most common foot injuries, with an incidence of approx. In contrast, fractures in zone III should primarily be treated surgically. There seems to be no reason to consider zone I and II fractures as two separate entities, as the outcomes in the two groups are similar. One RCT compared surgery and immobilization for zone III fractures: surgery led to statistically significant improvement of the outcome in all of the measured parameters.Ĭonclusion: Fractures in zones I and II should be treated with early functional therapy. Five studies compared fractures in zones I and II that were treated in the same manner, revealing similar outcomes. One RCT that compared functional therapy with immobilization for zone II fractures revealed no statistically significant difference. 46 days p<0.05) with early functional therapy, and similar outcomes for immobilization and surgery. The non-randomized studies revealed a faster return to full function (33 vs. 28 days p = 0.001), with otherwise similar outcomes. Two of these were randomized controlled trials (RCTs) in one RCT, patients given functional therapy returned to work much sooner than those treated with immobilization (11 vs. Results: Nine studies compared different treatments of zone I fractures. Studies were included that compared the treatment of two types of fracture in the same manner, or that compared two different treatments for a single type of fracture. Methods: The three fracture localizations according to Lawrence and Botte (zone I, proximal to the intermetatarsal joint between the fourth and fifth metatarsal bones zone II, in the area of the joint zone III, at the distal end of the joint) are analyzed on the basis of a systematic literature search. Nevertheless, no evidence-based treatment recommendations are available to date. Approximately 30% of metatarsal fractures affect the base of the fifth metatarsal bone. Background: Metatarsal fractures are among the most common foot and ankle injuries, with an annual incidence of 6.7 per 100 000 persons.
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