BACKGROUND: Fractures of the fifth metatarsal base (5th MT) are common foot injuries, but their treatment remains a subject of debate. The aim was to assess the midterm outcome of functionally treated epi-metaphyseal fractures (Lawrence and Botte types I and II) of the 5th MT. METHODS: This study was a longitudinal retrospective database study with prospective follow-up. Included were all patients with an acute, isolated fracture to the 5th MT base (types I and II). All patients were treated functionally: weightbearing as tolerated without immobilization. Fracture types and fracture characteristics (displacement <2 mm/>2 mm, articular involvement, number of fragments) were assessed retrospectively. Patient-reported outcome measures (PROMs) including the visual analog scale for foot and ankle (VAS FA) and the quality-of-life score (QoL) SF-12 were collected prospectively at 2- and 5-year follow-up. Out of 95 patients, 43 patients (45%) were included with a median follow-up of 5.7 (1.5) years. RESULTS: For both the VAS FA and SF-12, excellent scores were observed. For 30 patients (77%), longitudinal 2- and 5-year follow-up was available. No significant longitudinal changes could be observed for the VAS FA and SF-12. For both time points, neither fracture type nor characteristics significantly influenced any outcome parameter assessed. CONCLUSION: Functional treatment by full weightbearing and free range of motion led to excellent 5-year results for both type I and II fractures. Neither fracture location nor characteristics had a significant influence on the 5-year PROMs. LEVEL OF EVIDENCE: Level III, comparative study.
BACKGROUND:Fractures of the fifth metatarsal base (5th MT) are common foot injuries, but their treatment remains a subject of debate. The aim was to assess the midterm outcome of functionally treated epi-metaphyseal fractures (Lawrence and Botte types I and II) of the 5th MT. METHODS: This study was a longitudinal retrospective database study with prospective follow-up. Included were all patients with an acute, isolated fracture to the 5th MT base (types I and II). All patients were treated functionally: weightbearing as tolerated without immobilization. Fracture types and fracture characteristics (displacement <2 mm/>2 mm, articular involvement, number of fragments) were assessed retrospectively. Patient-reported outcome measures (PROMs) including the visual analog scale for foot and ankle (VAS FA) and the quality-of-life score (QoL) SF-12 were collected prospectively at 2- and 5-year follow-up. Out of 95 patients, 43 patients (45%) were included with a median follow-up of 5.7 (1.5) years. RESULTS: For both the VAS FA and SF-12, excellent scores were observed. For 30 patients (77%), longitudinal 2- and 5-year follow-up was available. No significant longitudinal changes could be observed for the VAS FA and SF-12. For both time points, neither fracture type nor characteristics significantly influenced any outcome parameter assessed. CONCLUSION: Functional treatment by full weightbearing and free range of motion led to excellent 5-year results for both type I and II fractures. Neither fracture location nor characteristics had a significant influence on the 5-year PROMs. LEVEL OF EVIDENCE: Level III, comparative study.
Entities:
Keywords:
Lawrence and Botte; fifth metatarsal fracture; fracture characteristics; functional treatment; outcome
Authors: Viktoria Herterich; Sebastian Felix Baumbach; Antonia Kaiser; Wolfgang Böcker; Hans Polzer Journal: Dtsch Arztebl Int Date: 2021-09-06 Impact factor: 5.594
Authors: George D Chloros; Christos D Kakos; Ioannis K Tastsidis; Vasileios P Giannoudis; Michalis Panteli; Peter V Giannoudis Journal: EFORT Open Rev Date: 2022-01-11
Authors: Patrick Pflüger; Michael Zyskowski; Michael Müller; Chlodwig Kirchhoff; Peter Biberthaler; Moritz Crönlein Journal: Eur J Med Res Date: 2021-12-20 Impact factor: 2.175
Authors: Patrick Pflüger; Michael Zyskowski; Christopher Völk; Chlodwig Kirchhoff; Peter Biberthaler; Moritz Crönlein Journal: Unfallchirurg Date: 2021-05-22 Impact factor: 1.000