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Surgical results of 5th metatarsal stress fracture using modified tension band wiring

  • Ankle
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to evaluate the surgical results of modified tension band wiring using two cortical screws for the treatment of fifth metatarsal stress fractures.

Methods

Forty-two patients with Torg’s type I and II fifth metatarsal stress fractures treated using the modified tension band wiring technique from 2005 to 2008 were evaluated retrospectively. All of the patients were elite athletes.

Results

The mean length of follow-up was 26 ± 16 months (12–62 months). All patients were able to return to their previous levels of sporting activity. The mean time to union as determined by CT was 75 ± 25 days (40–150 days). However, during follow-up, there were 4 delayed unions, 1 nonunion, and 4 refractures.

Conclusion

The described modified tension band wiring technique is a good alternative method for the surgical treatment of Torg’s type I and II fifth metatarsal stress fractures.

Level of evidence

Case series with no comparison group, retrospective case series, Level IV.

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References

  1. Clapper M, O’Brien T, Lyons P (1995) Fractures of the fifth metatarsal: analysis of a fracture registry. Clin Orthop Relat Res 315:238–241

    PubMed  Google Scholar 

  2. Dameron T (1975) Fractures and anatomical variations of the proximal portion of the fifth metatarsal. J Bone Joint Surg Am 57:788–792

    PubMed  Google Scholar 

  3. Delee J, Evans J, Julian J (1983) Stress fracture of the fifth metatarsal. Am J Sports Med 11:349–353

    Article  PubMed  CAS  Google Scholar 

  4. Eils E, Streyl M, Linnenbecker S, Thorwesten L, Volker K, Rosenbaum D (2004) Characteristic plantar pressure distribution patterns during soccer-specific movements. Am J Sports Med 32:140–145

    Article  PubMed  Google Scholar 

  5. Glasgow M, Naranja R Jr (1997) Analysis of failed surgical management of fractures of the base of the fifth metatarsal distal to the tuberosity: the Jones fracture. J Pediatr Orthop 17:277–278

    Google Scholar 

  6. Hulkko A, Orava S, Nikula P (1985) Stress fracture of the fifth metatarsal in athletes. Ann Chir Gynaecol 74:233–238

    PubMed  CAS  Google Scholar 

  7. Hulkko A, Orava S (1987) Stress fracture in athletes. Int J Sports Med 8:221–226

    Article  PubMed  CAS  Google Scholar 

  8. Jones R (1902) I. Fracture of the Base of the Fifth Metatarsal Bone by Indirect Violence. Ann Surg 35:697–700

    PubMed  CAS  Google Scholar 

  9. Josefsson P, Karlsson M, Redlund-Johnell I, Wendeberg B (1994) Jones fracture surgical versus nonsurgical treatment. Clin Orthop Relat Res 299:252–255

    PubMed  Google Scholar 

  10. Kavanaugh J, Brower T, Mann R (1978) The Jones fracture revisited. J Bone Joint Surg Am 60:776–782

    PubMed  CAS  Google Scholar 

  11. Larson C, Almekinders L, Taft T, Garrett W (2002) Intramedullary screw fixation of Jones fractures. Am J Sports Med 30:55–60

    PubMed  Google Scholar 

  12. Lawrence S, Botte M (1993) Jones’ fractures and related fractures of the proximal fifth metatarsal. Foot Ankle 14:358–365

    PubMed  CAS  Google Scholar 

  13. Mindrebo N, Shelbourne K, Van Meter C, Rettig A (1993) Outpatient percutaneous screw fixation of the acute Jones fracture. Am J Sports Med 21:720–723

    Article  PubMed  CAS  Google Scholar 

  14. Mologne T, Lundeen J, Clapper M, O’Brien T (2005) Early screw fixation versus casting in the treatment of acute Jones fractures. Am J Sports Med 33:970–975

    Article  PubMed  Google Scholar 

  15. Porter D, Duncan M, Meyer S (2005) Fifth metatarsal Jones fracture fixation with a 4.5-mm cannulated stainless steel screw in the competitive and recreational athlete. Am J Sports Med 33:726–733

    Article  PubMed  Google Scholar 

  16. Portland G, Kelikian A, Kodros S (2003) Acute surgical management of Jones’ fractures. Foot Ankle Int 24:829–833

    PubMed  Google Scholar 

  17. Quill G Jr (1995) Fractures of the proximal fifth metatarsal. Orthop Clin North Am 26:353–361

    PubMed  Google Scholar 

  18. Rosenberg G, Sferra J (2000) Treatment strategies for acute fractures and nonunions of the proximal fifth metatarsal. J Am Acad Orthop Surg 8:332–338

    PubMed  CAS  Google Scholar 

  19. Sarimo J, Rantanen J, Orava S, Alanen J (2006) Tension-band wiring for fractures of the fifth metatarsal located in the junction of the proximal metaphysis and diaphysis. Am J Sports Med 34:476–480

    Article  PubMed  Google Scholar 

  20. Torg J, Balduini F, Zelko R, Pavlov H, Peff T, Das M (1984) Fractures of the base of the fifth metatarsal distal to the tuberosity. Classification and guidelines for non-surgical and surgical management. J Bone Joint Surg Am 66:209–214

    PubMed  CAS  Google Scholar 

  21. Wright R, Fischer D, Shively R, Heidt R, Nuber G (2000) Refracture of proximal fifth metatarsal (Jones) fracture after intramedullary screw fixation in athletes. Am J Sports Med 28:732–736

    PubMed  CAS  Google Scholar 

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Correspondence to Young Uk Park.

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Lee, K.T., Park, Y.U., Young, K.W. et al. Surgical results of 5th metatarsal stress fracture using modified tension band wiring. Knee Surg Sports Traumatol Arthrosc 19, 853–857 (2011). https://doi.org/10.1007/s00167-011-1406-3

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  • DOI: https://doi.org/10.1007/s00167-011-1406-3

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