• Title/Summary/Keyword: Fifth metatarsal base

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Surgical Treatment of the Fifth Metatarsal Base Fracture Using Multiple Kirschner Wires (다발성 Kirschner 강선을 이용한 제 5중족골 기저부 골절의 수술적 치료)

  • Kim, Jihyeung;Kim, Jang Woo;Lee, Jeong Ik;Kim, Sang Kil;Rhee, Seung Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.1
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    • pp.24-28
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    • 2014
  • Purpose: The purpose of this study is to evaluate the clinical and radiographic results of internal fixation using multiple Kirschner wires (K-wires) for the fifth metatarsal base fracture. Materials and Methods: We retrospectively reviewed 14 patients with a displaced fifth metatarsal base fracture. We measured the distance of fracture displacement on the foot oblique radiograph pre- and post-operatively. We evaluated the clinical results using the visual analog pain scale at six weeks and three months postoperatively and the American Orthopaedic Foot and Ankle Society (AOFAS) mid-foot score at six months postoperatively. Results: In our series, 10 cases were zone I fracture and four cases were zone II fracture. We achieved anatomical reduction and bony union in all of our cases. The average time to bone union was 43 days. The degree of pain around the fifth metatarsal base was significantly decreased after surgery. The average AOFAS score was 95 at six months postoperatively. Conclusion: Multiple K-wire fixation is a relatively simple fixation method for displaced fifth metatarsal base fractures. If we place a K-wire into the medial cortex of the fifth metatarsal, we could prevent proximal migration of the K-wire.

Operative Treatment for Avulsion Fracture of Base of the Fifth Metatarsal (제5 중족골 기저부 견열 골절의 수술적 치료)

  • Kim, Yong-Chan;Chung, Whan-Yong;Cho, Seong-Jin;Kim, Yong-Sang;Jo, Sung-Kwun
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.92-96
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    • 2004
  • Purpose: To analyze the clinical and radiological results of the operative treatment in the avulsion fracture on the base of the fifth metatarsal. Materials and Methods: We studied retrospectively, 11 patients of avulsion fracture on the base of the fifth metatarsal operated and followed over 1 year, from February 2000 to May 2002. There were eight men and three women and the average age was 39 years old. The mean follow up period was 14 months. Ten cases were slip-down and one case was fall from a height injuries. We used the modified Foot Score by Wiener for the clinical evaluation, and analyzed the time of union and state of reduction radiologically. Results: In clinical results, we had ten excellent and one good cases by the modified Foot Score at last follow-up. In radiologic results, the complete bony union was achieved in all cases and the duration of the bony union was 37 days in average. Conclusion: We had good result for the avulsion fractures on the base of the fifth metatarsal treated by the operation. This study shows the operation was recommended for the moderate and severe displacement of the avulsion fractures on the base of the fifth metatarsal.

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Treatment of Fifth Metatarsal Base Fracture Using Tension Band Wiring (인장대 강선 고정술을 이용한 제5 중족골 기저부 골절의 수술적 치료)

  • Ahn, Jong-Kuk;Chung, Hyung-Jin;Bae, Su-Young;Park, Ji-Yong
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.1
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    • pp.18-21
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    • 2011
  • Purpose: To evaluate the clinical and radiological results of internal fixation with tension band wiring for the fracture at the base of fifth metatarsal bone. Materials and Methods: From January 2008 to December 2009, 15 cases with displaced fracture at the base of fifth metatarsal were analyzed and average follow up period was 13.8 months. Lawrence classification was used to classify fracture type. We evaluated clinical results by American Orthopedic Foot Ankle Society (AOFAS) midfoot score and radiological results by union time. Complications was also checked. Results: According to classification, zone I fracture were 11 cases and zone II fracture were 4 cases. Bony union was achieved in all cases after 7 weeks. In the final follow-up, average AOFAS score was 94. There were no complications except hardware irritation. Conclusion: Satisfactory results were obtained after tension band wiring for the fifth Metatarsal base fracture in zone I fracture or comminuted zone II fracture for which it is not easy to be fixed with screw.

Operative Treatment of Fractures of the Fifth Metatarsal Base (제5 중족골 기저부 골절의 수술적 치료)

  • Suh, Jin-Soo;Kim, Jung-Hoon;Choi, Jun-Young
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.2
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    • pp.189-196
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    • 2008
  • Purpose: Nonunions and delayed unions are possible complications of fractures of fifth metatarsal base. We tried to report the results of the surgical treatment, which is not prevalent yet. Materials and Methods: Retrospective study of thirty nine patients undergoing operation at our institution between 2003 and 2008 was conducted. Six patients were excluded with loss of follow up before bony union, multiple trauma, pediatric fractures, stress fracture, open fracture. There were 18 males and 15 females with 45.1 years old mean age. The average follow-up period was 18.3 months. We used a midfoot scoring system of AOFAS for clinical assessment and radiologic findings to evaluate bony union, alignment. Results: According to Lawrence's classification, Zone 1 fractures were thirteen and Zone 2 were twenty. Average AOFAS score was 93.61. Conclusion: Early operative treatment with cannulated screw fixation in fractures of the fifth metatarsal base is thought to be an useful and easy treatment option with faster rates of union.

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Fifth Metatarsal Stress Fracture (운동선수의 제5 중족골 피로골절)

  • Lee, Kyung-Tai;Park, Young-Uk;JeGal, Hyuk;Kim, Jun-Beom
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.2
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    • pp.87-93
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    • 2012
  • 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.

The Short Term Outcome of Surgical Treatment for the Fifth Metatarsal Base Fracture Using a Headless Cannulated Compression Screw (제 5중족골 기저부 골절의 무두유관압박나사를 사용한 수술적 치료의 단기 추시 결과)

  • Chon, Je-Gyun;Choi, Hyun;Kim, Jun-Beom;Sun, Doo-Hun;Shin, Sang-Yeop
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.3
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    • pp.131-134
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    • 2016
  • Purpose: This study aimed to evaluate the outcomes, including the complications, of open reduction and internal fixation using a headless cannulated compression screw for a fifth metatarsal base fracture. Materials and Methods: We retrospectively investigated 11 patients with 5th metatarsal base fracture who were treated with a headless cannulated compression screw. The mean follow-up period was 13 months (8~15 months), and the mean age was 46.5 years (21~70 years). We analyzed the patients' sex, age, time to union, amount of fracture displacement, and complications. The American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score was used for clinical assessment. Results: The average amount of displacement decreased significantly from 3.4 mm (2.1~5.2 mm), preoperatively, to 0.4 mm (0~1.3 mm), postoperatively (p<0.001). The average bone union time was 54.1 days (41~68 days). There were no complications, such as a metal failure, irritation, and loss of a reduction. The mean AOFAS midfoot score was 97.7 (90~100) at 6 months, postoperatively. Conclusion: We suggest that a headless cannulated compression screw for 5th metatarsal base fracture is a useful and alternative method for a firm fixation without complications.

Conservative Treatment of Nondisplaced Fifth Metatarsal Base Zone I and II Fractures (제5 중족골 기저부 제 I, II구역 비전위성 골절의 보존적 치료)

  • Sung, Ki-Sun;Koh, Kyoung-Hwan;Koo, Kyung-Hyo;Park, Jae-Chul
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.2
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    • pp.185-188
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    • 2008
  • Purpose: Zone I fractures of the fifth metatarsal bone can generally be treated by conservative methods while both surgical and conservative methods are used for zone II fractures. However, the clinical results of conservative treatment have been rarely reported. The purpose of this study is to report the clinical results of conservative treatment for zone I and II nondisplaced fractures. Materials and Methods: Between July 2007 and August 2008, consecutive thirty seven patients (38 fractures) with zone I and II fractures of the fifth metatarsal bone were treated with tolerable weight bearing and minimum duration of immobilization based on pain on weight bearing. We evaluated the duration of immobilization, time to clinical and radiographic union, and time to pre-injury activity level. Results: Clinical and radiological union were achieved in all patients without any complications including malunion or nonunion. The mean duration of immobilization was 28.7 days. The mean 33.1 days and 48.9 days were required for clinical union and radiographic union respectively, after the initial injury. The mean time to pre-injury activity level was 4.8 months. Conclusion: Our study shows that the acute nondisplaced zone I, II fracture of fifth metatarsal bone can be treated effectively using tolerable weight bearing and minimum duration of immobilization, which is based on the pain on weight bearing.

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Avascular Necrosis of the Fifth Metatarsal Head - A Case report - (제 5 중족골 두 무혈성 괴사 - 1례 보고 -)

  • Park, In-Heon;Song, Kyung-Won;Muhn, Young-Wan;Joe, Myoung-Il
    • Journal of Korean Foot and Ankle Society
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    • v.4 no.1
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    • pp.44-47
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    • 2000
  • Freiberg's infarction involving the fifth metatarsal head is very rare condition. The authors experienced a case of avascular necrosis of the fifth metatarsal head and base of the proximal phalanx in a 27-year-old female patient. Involved bones were excised and internally fixed with 2 K-wires after autogenous cancellous bone grafting. Pain was relieved, and an excellent clinical result was obtained at the follow-up examination six months after the surgery.

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Chondroblastoma of the Base of Fifth Metatarsal Bone associated with Secondary Aneurysmal Bone Cystic Change - A Case Report - (제 5 중족골 기저부의 이차 동맥류성 골낭종변화를 동반한 연골모세포종 - 증례 보고 -)

  • Son, Hyun-Jin;Jang, Kyu-Yun;Lee, Dong-Geun;Lee, Sang-Yong;Kim, Jung-Ryul
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.1
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    • pp.45-49
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    • 2004
  • Chondroblastoma is a benign chondroid-forming tumor usually originating in the epiphysis. The base of metatarsal bone contains neither an epiphysis nor a secondary ossification center and so is the rare site of chondroblastoma. Here, we present a case of chondroblastoma of the base of fifth metatarsal bone in 34-year-old man. Histologically, the osteoclast-like giant cells were abundant enough to simulate a giant cell tumor. And the chondroid intercellular matrix was intermixed but scanty. However, the background mononuclear cells showed irregular and indented nuclei with longitudinal clefts and positive immunoreactivity for S-100 protein, as the evidence of chondroblasts.

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Results of Non-Operative Treatment of the Zone I, II Fifth Metatarsal Base Fracture (제5중족골 제1, 2구역 골절의 비수술적 치료 결과)

  • Choi, Young-Nak;Choi, Young-Rak;Seo, Jeong-Ho;Lee, Ho-Seong;Kim, Sang-Woo;Jeong, Jae-Jung
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.4
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    • pp.207-211
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    • 2011
  • Purpose: To evaluate the results of conservative treatment of zone I, II $5^{th}$ metatarsal base fracture. Materials and Methods: Between May 2004 and June 2010, a total of 58 patients of zone I, II $5^{th}$ metatarsal base fractures were included in this study. The mean length of follow-up was 13.5 months (12~36 months). All of the patients were treated with full-weight-bearing short leg cast immobilization for 4 weeks and wooden sole shoes for 4 weeks. The results were evaluated about the radiographic union, the midfoot scale of American Orthopaedic Foot and Ankle Society (AOFAS), the tenderness on fracture site and other complications. Results: All patients were able to return to their prior levels of activity. The mean time for union as shown on radiographs was 45.5 days, and the mean midfoot scale of AOFAS was 99.7 points. There were no nonunions or refractures during the follow-up. Conclusion: The conservative treatment with full-weight-bearing short leg cast and wooden sole shoes seems to give good results for zone I, II $5^{th}$ metatarsal base fracture.