2/26/2024 0 Comments Fifth metatarsal fracture![]() Or re-fracture due to the shape of their foot. Some patients may be at greater risk for poor healing Another rare but serious complication is a re-fracture after fixation. The metatarsal fracture may not heal and can become a nonunion. Some complications can result in the need for repeat surgery. Risks and ComplicationsĪll surgeries come with possible complications, including the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots. The screw is not usually removed unless it causes discomfort. Some fractures may require bone grafting and have longer recoveries. You can expect to return to full activity 3-4 months after a typical fracture. Weightīearing in a removable walking boot is allowed after that. This could last as long as six weeks (sometimes longer based on healing and other factors such as diabetes). Lengthy healing times and risk of refracture may be reasons for surgical repair in these fractures.įor the first 7-14 days after surgery, you may be allowed to bear weight through your heel but typically not through the front of your foot. These typically are stress fractures,Īnd may be associated with symptoms prior to the fracture, or with minimal trauma that still results in a fracture. Zone 3 fractures happen at the junction of the wide portion of the bone with the shaft of the fifth metatarsal.Surgery is common for theseįractures due to the risk for delayed healing or reinjury. They also are at risk of refracture even after healing. These fractures are known to have a higher chance of not healing (nonunion). They occur at the intersection between the base and the shaft of the fifth metatarsal. Zone 2 fractures are known as Jones fractures.These fractures typically are treated without surgery using a cast, boot, or hard-soled shoe and tend to heal within 6-8 weeks. Zone 1 fractures are avulsion or chip fractures that occur at the tip of the base of the fifth metatarsal.Decreased time to union, high union rates, and accelerated return to sport can be expected in athletes who undergo this procedure.The base of the fifth metatarsal is divided into three fracture zones. If surgical intervention is warranted, intramedullary screw fixation of proximal fifth metatarsal fractures is the preferred treatment option. Nonunion rates are high in patients who undergo nonsurgical treatment, and surgical intervention is controversial however, primary surgical fixation with the use of a cannulated intramedullary screw is technically feasible and affords reliable outcomes. Acute fractures in the metaphyseal-diaphyseal region of the proximal fifth metatarsal may be difficult to manage. The results of surgical and nonsurgical management of Jones fractures and recommended postoperative management strategies are reviewed. The patient underwent cannulated intramedullary screw fixation and successfully returned to sports activity. The video discusses the case presentation of a 23-year-old male collegiate athlete with a traumatic Jones fracture. The video provides an overview of the anatomy, pathogenesis, and treatment options for the management of Jones fractures. This video demonstrates intramedullary screw fixation of metaphyseal-diaphyseal injuries, or Jones fractures, of the base of the fifth metatarsal. Athletes and highly active individuals may elect to undergo surgical fixation to accelerate recovery and return to sport. Although the management of Jones fractures is controversial, most studies agree that a period of non-weight-bearing is necessary to allow for healing however, delayed union is common. High rates of nonunion or delayed union are observed in this region secondary to a vascular watershed. Although proximal tuberosity fractures often are managed nonsurgically, injuries in the metaphyseal-diaphyseal region (commonly referred to as Jones fractures) are problematic. This fracture pattern was initially described by Sir Robert Jones in 1902 after he sustained the injury during a dance accident. Fractures of the base of the fifth metatarsal are one of the most common fractures that occur in the foot.
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