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Combined Surgical Therapy and Orthotic Management of Stress and Tuberosity Avulsion Fracture of the Fifth Metatarsal Bone

A Case Report

Nikica Darabos, MD, PhD ^*, Karlo Obrovac, MD , Nikica Knez, MD , Anela Darabos, MD , Damir Hudetz, MD, PhD ^* and Esmat Elabjer, MD, PhD ^*

^* Sports Trauma Department, University Clinic of Traumatology, Medical School, University of Zagreb, Zagreb, Croatia.
Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Croatia.
Department of Traumatology, General Hospital Varazdin, Varazdin, Croatia.
Scientific Unit, General Hospital Varazdin, Varazdin, Croatia.

Corresponding author: Nikica Darabos, MD, PhD, Sports Trauma Department, University Clinic of Traumatology, Medical School, University of Zagreb, Draskoviceva 19, Zagreb, 42000 Croatia. (E-mail: darabos.dr{at}vz.t-com.hr)

Abstract

The incidence of fifth metatarsal fracture is somewhat common in sports and can be complicated in nature. Fractures of the fifth metatarsal can occur at a number of locations. Although some of these fractures respond well to conservative treatment, others have been notoriously hard to heal, with high rates of nonunions and other complications. Foot orthotic devices are commonly used as aids in the treatment of foot problems. In our case, we considered the combined effect of the surgical treatment and application of the custom-made foot orthoses. Special attention was taken with adjustments to the orthotic devices along and beneath the affected regions of the foot for adequate pain management and quick recovery to return to normal sports activities. Requirements for computer aided design/computer aided manufacturing orthotic design and manufacturing in this case were specific and considerably different from the usual procedure. (J Am Podiatr Med Assoc 99(6): 529–535, 2009)