Andrew C Gray1, Brian P Rooney, Roland Ingram. 1. Orthopaedic and Trauma Department, Edinburgh Royal Infirmary, 15 Little France, Edinburgh EH16 4SU, UK. andrewgray@doctors.org.uk
Abstract
BACKGROUND: Tuberosity 'avulsion' fractures of the proximal fifth metatarsal are common injuries, but with few comparisons of conservative treatment options. OBJECTIVE: This study prospectively compared two commonly used conservative treatment methods. METHODS:37 patients were allocated to treatment in either a plaster slipper (n=20) or tubi-grip support (n=17) for a period of 6 weeks. Patients were assessed at 2, 6 and 12 weeks after injury using a modified foot score which measured the level of pain and dysfunction. A radiograph was taken at 12 weeks. A Mann-Whitney U test compared median foot scores between the treatment groups at each review (p-value of 0.05 or less was deemed significant). RESULTS: A significantly (p=0.02) better foot score was measured in the plaster group at 2 weeks after injury (median score 68 (plaster group) compared to 57 (tubi-grip group)). However by the 6- and 12-week stages, the scores were comparable. Radiographs indicated two patients in each group with no clear evidence of union after 12 weeks. One patient remained symptomatic and required surgical treatment. CONCLUSIONS: The eventual clinical and radiological outcomes were comparable. During the initial 2 weeks, patients treated in plaster had a better-combined level of pain and function.
RCT Entities:
BACKGROUND:Tuberosity 'avulsion' fractures of the proximal fifth metatarsal are common injuries, but with few comparisons of conservative treatment options. OBJECTIVE: This study prospectively compared two commonly used conservative treatment methods. METHODS: 37 patients were allocated to treatment in either a plaster slipper (n=20) or tubi-grip support (n=17) for a period of 6 weeks. Patients were assessed at 2, 6 and 12 weeks after injury using a modified foot score which measured the level of pain and dysfunction. A radiograph was taken at 12 weeks. A Mann-Whitney U test compared median foot scores between the treatment groups at each review (p-value of 0.05 or less was deemed significant). RESULTS: A significantly (p=0.02) better foot score was measured in the plaster group at 2 weeks after injury (median score 68 (plaster group) compared to 57 (tubi-grip group)). However by the 6- and 12-week stages, the scores were comparable. Radiographs indicated two patients in each group with no clear evidence of union after 12 weeks. One patient remained symptomatic and required surgical treatment. CONCLUSIONS: The eventual clinical and radiological outcomes were comparable. During the initial 2 weeks, patients treated in plaster had a better-combined level of pain and function.
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