A study of metatarsal fractures in children

Owen, Richard; Hickey, F.G.; Finlay, D.

doi:10.1016/0020-1383(95)00121-o

Cited by 56 publications

(30 citation statements)

References 2 publications

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“…Owen et al [2] reported on metatarsal fractures in children. They found that the highest rate of fracture in childhood involved the fifth metatarsal (45 %) and the lowest rate of fracture was the first metatarsal (22 %).…”

Section: Discussionmentioning

confidence: 99%

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Childhood metatarsal shaft fractures: Treatment outcomes and relative indications for surgical intervention

Robertson

Roocroft

Edmonds

2012

Journal of Children's Orthopaedics

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Purpose Although the epidemiology of childhood metatarsal fractures is known, the appropriate treatment has not been elucidated. This study was undertaken to ascertain the outcomes of both non-operative and surgical treatment of these common childhood injuries and to discern any indications for treatment. Methods A retrospective review was performed of all children identified from 2006 to 2007 with a metatarsal fracture by the ICD-9 code, 825.25. After dividing the cohort into groups by age in years (0-5, 6-10, 11-15, 16 and older), we collected demographics, mechanism of injury, and associated injuries, as well as clinical information concerning metatarsal involvement, treatment, complications, return to activities/sports, and residual pain. Radiographic information was also collected, including fracture location, displacement, comminution, and union. Results We identified 337 children that met the criteria. The mean age was 10.5 years (range 1.8-20.6). Only ten children had surgery. Only age, multiplicity of metatarsal fracture, and fracture translation was statistically different between the non-surgical and surgical cohorts. None of the patients under the age of 12 years underwent surgical intervention (p = 0.005). Evidence of multiple metatarsal fractures was seen in only 28 % of the non-surgical group compared to 70 % of the surgical group (p = 0.009). The amount of fragment translation significantly correlated with a decision for surgery (p = 0.001), but not angulation. Logistic regression demonstrated that, for every year of age, the likelihood for surgery increased by 32 % and that children were 6.6 times more likely to have surgery if they had multiple metatarsal fractures. Complete union was achieved in 84.6 %, with no difference in treatment groups regarding the time of release to full activities, and of the 50 delayed unions, only two required subsequent operative interventions. Return to sports took longer in the operative group, with a mean of 4.0 compared to 2.1 months (p \ 0.001). Only 14 children complained of residual posttreatment pain and all of those cases had been treated without surgery. The presence of post-treatment pain did not correlate with the mechanism of injury or the amount of displacement. Conclusion Each metatarsal injury pattern is unique and surgeons should utilize their clinical judgment to determine appropriate treatment; however, there appears to be some relative indications for surgical treatment. Whereas open and articular fractures may be absolute indications for surgery, the relative indications for surgical intervention in metatarsal shaft fractures appear to be adolescent age and multiple fractures. Successful non-surgical management may consist of a short-leg walking cast for a mean of 4 weeks and activity restrictions for an additional month. However, children should be followed to radiographic union, since 15.4 % may have a delayed union and 4.3 % have short-term residual problems related to the injury.

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Section: Discussionmentioning

confidence: 99%

“…The epidemiology of metatarsal fractures in children has been well established [2,3]. It has been shown that the fracture pattern and severity of injury vary according to age and mechanism of injury [4].…”

Section: Introductionmentioning

confidence: 99%

Childhood metatarsal shaft fractures: Treatment outcomes and relative indications for surgical intervention

Robertson

Roocroft

Edmonds

2012

Journal of Children's Orthopaedics

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“…Some of these studies have focused primarily on hospitalized children, 18,19 very severely injured children, [20][21][22] speci c injury types such as fractures 23,24 or on speci c injury causes such as traf c-related accidents. [25][26][27] However, for an accurate view on the injury problem in children, the focus should not be on a speci c selection of injuries but on all injuries including those of minor severity, as was the aim of our study.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of injured children attending the emergency department: patients potentially in need of rehabilitation

Sturms¹,

Sluis

Groothoff

et al. 2002

Clin Rehabil

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Characteristics of injured children attending the emergency department Sturms, L.M.; van der Sluis, C.K.; Groothoff, J.W.; Ten Duis, H.J.; Eisma, W.H. CopyrightOther than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons).Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Objective: To provide an epidemiological overview of the characteristics of injured children and to compare hospitalized and nonhospitalized injured children to identify predictors of hospitalization and, with that, possible predictors of disablement. Design: Retrospective analysis of data obtained from a computerized trauma registration system and medical records. Setting:

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“…3Y5 To the best of our knowledge, there is only 1 study that does not have treatment recommendations regarding the incidence of metatarsal fractures in children . 2 There are no reports in the literature on the management of these injuries in children. To this point, the treatment of pediatric metatarsal fractures of the fifth toe is based on the adult literature.…”

mentioning

confidence: 98%

“…Fractures of the fifth metatarsal are the most common metatarsal fractures in children. 2 Exposure to high-demand sports and activities has made this fracture more common. Nearly all of the literature on these metatarsal base fractures is based on adult patients.…”

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confidence: 99%

Fractures of the Fifth Metatarsal in Children and Adolescents

Herrera-Soto

Scherb

Duffy

et al. 2007

Journal of Pediatric Orthopaedics

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Most fractures of the fifth metatarsal in the pediatric population do well clinically after a course of walking cast, unless the fracture is an intra-articular displaced fracture type or the fracture occurs in the proximal diaphyseal area. Fixation of Jones fractures in active adolescents should be considered to allow faster return to regular activities and prevent refracture. We recommend non-weight bearing casts for all angulated or displaced intra-articular injuries to avoid delays in healing and angulation. From our series, it is evident that most pediatric fifth metatarsal fractures behave as those found in adults and can be treated similarly.

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A study of metatarsal fractures in children

Cited by 56 publications

References 2 publications

Childhood metatarsal shaft fractures: Treatment outcomes and relative indications for surgical intervention

Childhood metatarsal shaft fractures: Treatment outcomes and relative indications for surgical intervention

Characteristics of injured children attending the emergency department: patients potentially in need of rehabilitation

Fractures of the Fifth Metatarsal in Children and Adolescents

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