Jeffrey Yates1, Iain Feeley2, Sanskriti Sasikumar1, Gurender Rattan1, Ailish Hannigan1, Eoin Sheehan3. 1. Graduate Entry Medical School, University of Limerick, Limerick, Ireland. 2. Midlands Regional Hospital, Tullamore, Co Offaly, Ireland. Electronic address: iainfeeley@rcsi.ie. 3. Midlands Regional Hospital, Tullamore, Co Offaly, Ireland.
Abstract
BACKGROUND: This study assesses the outcomes of surgical vs. conservative management in the treatment of the Jones fracture. MATERIALS AND METHODS: A systematic review using four databases from their inception until September 2014 was undertaken. Six studies were found evaluating operative therapy compared to conservative treatment. RESULTS: Six relevant studies were included, with a total of 237 patients. Of these, 51% were treated non-operatively, and 49% had surgical intervention. Those in the non-operative group were found to have a significantly higher odds ratio (OR) of fracture non-union (OR 5.74, 95% confidence interval (CI) 2.65-12.40, P<0.001). Studies also reported a prolonged healing time and a longer time to return to sports. Of the trials with time to union as an outcome measure, 3 of 4 trials found favourable results in the operative cohort. CONCLUSIONS: Surgical intervention is recommended for patients presenting with a Jones fracture as it is found to result in a lesser non-union rate and an improved time to union.
BACKGROUND: This study assesses the outcomes of surgical vs. conservative management in the treatment of the Jones fracture. MATERIALS AND METHODS: A systematic review using four databases from their inception until September 2014 was undertaken. Six studies were found evaluating operative therapy compared to conservative treatment. RESULTS: Six relevant studies were included, with a total of 237 patients. Of these, 51% were treated non-operatively, and 49% had surgical intervention. Those in the non-operative group were found to have a significantly higher odds ratio (OR) of fracture non-union (OR 5.74, 95% confidence interval (CI) 2.65-12.40, P<0.001). Studies also reported a prolonged healing time and a longer time to return to sports. Of the trials with time to union as an outcome measure, 3 of 4 trials found favourable results in the operative cohort. CONCLUSIONS: Surgical intervention is recommended for patients presenting with a Jones fracture as it is found to result in a lesser non-union rate and an improved time to union.
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