Fractures of the fifth metatarsal diagnosis and treatment. Acute fractures of the proximal fifth metatarsal bone: development of classification and treatment recommendations based on the current evidence. Polzer H, Polzer S, Mutschler W, Prall WC. Proximal fifth metatarsal fractures: anatomy, classification, treatment and complications. The intraosseous blood supply of the fifth metatarsal: implications for proximal fracture healing. The intraosseous and extraosseous vascular supply of the fifth metatarsal: implications for fifth metatarsal osteotomy. McKeon KE, Johnson JE, McCormick JJ, Klein SE. Fractures of the base of the fifth metatarsal distal to the tuberosity. Jones fractures and related fractures of the proximal fifth metatarsal. Fracture of the base of the fifth metatarsal bone by indirect violence. Demographics and outcome of metatarsal fractures. A study of metatarsal fractures in children. The epidemiology of metatarsal fractures. Although nonoperatively treated patients indicated decreased mental quality of life, our study indicates that proximal fifth metatarsal fractures can safely be treated nonoperatively without the risk of nonunion, with fewer complications and lower healthcare costs. The foot function and quality of life were mainly affected by comorbidity, rather than fracture and treatment-related variables. Overall, the clinical and patient-reported outcome was good. The total healthcare costs for operative treatment were 4.2 times higher compared to nonoperative treatment (€1960 vs. Nonunion was recorded in only one (nonoperatively) treated patient. Overall complication rate was 5.9% (4.1 vs. The FFI and physical SF-36 were predominantly affected by a history of mobility impairment and pre-existent cardiovascular diseases, whereas mental SF-36 correlated significantly with higher ASA-score. The median FFI, physical SF-36, and VAS scores did not significantly differ between nonoperatively and operatively treated patients. Outcome was assessed using the patient files, anterior-posterior and oblique X-rays, foot function index (FFI), visual analog score (VAS), and SF-36 questionnaires. Twenty-three demographic, fracture, and treatment characteristics were assessed as well as the healthcare costs. Median follow-up was 37.5 (IQR 20.8–52.3) months with a minimal follow-up of 6 months. In the operative group, 21 were zone 1 and 10 zone 2 fractures. MethodsĪ retrospective adult cohort study including 152 proximal fifth metatarsal fractures: 121 nonoperatively and 31 operatively treated. To optimize the treatment strategy and reduce treatment costs of proximal fifth metatarsal fractures, clinical and patient-reported outcome, and its determinants were addressed.
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