Early operative fixation of stress fractures of the proximal diaphysis of the fifth metatarsal has been advocated because of the high potential for delayed union, nonunion, and refracture. Case reports are given of three athletes with stress fractures of the proximal shaft of the fifth metatarsal who were treated nonoperatively and who returned to early athletic participation without recurrent symptoms or refracture. Treatment of this injury should be individualized because of the potential for nonunion and the ability of this fracture to heal.
In knee ligament reconstruction procedures, soft tissue grafts are often secured to bone with sutures tied around screws used as tie-down posts. The technique of utilizing screw angulation to preserve the tension in the graft is demonstrated. Angulation of the fixation screw can enhance the attachment of the graft to bone by maintaining or increasing the tension applied to the graft as the screw is advanced to its final position in the bone.
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