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Journal of the American Podiatric Medical Association, Vol 85, Issue 9 473-480, Copyright © 1995 by American Podiatric Medical Association

JOURNAL ARTICLE

Clinical perspective of the treatment of fifth metatarsal fractures

MK O'Shea, W Spak, S Sant'Anna and C Johnson
University of Southern California at Los Angeles Medical Center, USA.

The authors present a retrospective study of fifth metatarsal fractures. These fractures include Jones fractures, avulsion fractures, spiral and oblique midshaft fractures, and the author-termed "tulip" fracture (impaction fracture of the fifth metatarsal head). These fractures were fixated with the cannulated screw, Kirschner wires, and cerclage loop wires combined with Kirschner wires. A one-way analysis of variance (ANOVA) was performed on the data to test for any significant difference in the fixation type used and the overall healing time. The ANOVA was found to be nonsignificant, F(2,10) = 0.379, p < 0.05. Therefore, it can be concluded that all three types of fixation work equally well. Other analyses were performed on each of the three specific types of fractures to see if there was any difference in fixating the fracture versus no fixation and immobilization. This information was significant for only the Jones fracture, F(1,5)2.23, p < 0.05, meaning that Jones fractures heal in a significantly shorter amount of time when some type of open reduction internal fixation is used. Since there was no difference in healing time between the different types of fixation, the authors advise that the cannulated screw be strongly considered because of its efficiency of insertion. In addition, because of the vascularity, muscle insertions, and motion related to the fifth metatarsal, the authors recommend that most Jones fractures be fixated for a more rapid return to function.


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 Am. J. Roentgenol.Home page
D. G. Pao, T. E. Keats, and R. G. Dussault
Avulsion Fracture of the Base of the Fifth Metatarsal Not Seen on Conventional Radiography of the Foot: The Need for an Additional Projection
Am. J. Roentgenol., August 1, 2000; 175(2): 549 - 552.
[Abstract] [Full Text] [PDF]


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Copyright © 1995 by the American Podiatric Medical Association.