Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
권호 표지

Fifth Metatarsal Stress Fracture

운동선수의 제5 중족골 피로골절

  • Lee, Kyung-Tai (Foot and Ankle Service, KT Lee's Orthopedic Hospital) ;
  • Park, Young-Uk (Foot and Ankle Service, KT Lee's Orthopedic Hospital) ;
  • JeGal, Hyuk (Foot and Ankle Service, KT Lee's Orthopedic Hospital) ;
  • Kim, Jun-Beom (Department of Orthopedic Surgery, Sun General Hospital)
  • Received : 2012.04.14
  • Accepted : 2012.05.16
  • Published : 2012.06.15
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Abstract

Fractures located at the metaphyseal/diaphyseal junction at the base of the fifth metatarsal were first described by Sir Robert Jones in 1902. However, ever since, there has been disagreement and debate regarding the diagnosis, classification, pathomechanics, the incidences, and potential causes of delayed unions and nonunions, and the optimal method of treatment. It appears to be widely agreed that proximal fractures of the metaphyseal/diaphyseal region of the fifth metatarsal are prone to delayed union or even nonunion. Several classifications of proximal fifth metatarsal stress fractures have been devised. Torg et al. classified fractures involving the proximal part of the diaphysis of the fifth metatarsal into three types. The Torg classification is a good grading system that can be used to determine the type of surgery needed as well as for the prediction of prognosis. The ''plantar gap'' might add to the decision-making process for surgery and improve the prediction of patient prognosis. In addition, the new classification using 'plantar gap' might be used for classification of fifth metatarsal stress fracture. Fifth metatarsal stress fractures can be treated conservatively or surgically, and excellent results have been reported for surgery with rapid recovery in athletes. Intramedullary screw fixation has become a popular form of fixation for fifth metatarsal stress fractures. Bone grafting presents the problems of a longer recovery time and additional skin incision for harvesting. The modified tension band wiring is an useful and simple option for surgical treatment of challenging fifth metatarsal stress fractures.

Keywords

References

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