Fractures of the Proximal Fifth Metatarsal: Selecting the Best Treatment Option

Dameron, Thomas B.

doi:10.5435/00124635-199503000-00006

Cited by 172 publications

(168 citation statements)

References 11 publications

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“…A fracture at the metaphyseal-diaphyseal junction, which extended beyond the fourth to fifth intermetatarsal articulation, was defined as a proximal diaphyseal fracture. A fracture at the metaphyseal-diaphyseal junction, not distally extended beyond the fourth to fifth intermetatarsal articulation, was defined as a Jones fracture [4,11,19], as determined by the attending surgeon's discretion (BC).…”

Section: Methodsmentioning

confidence: 99%

“…The mechanism of injury is believed to be an abduction force applied to the forefoot with simultaneous ankle plantar flexion [3,17,19,22]. A proximal diaphyseal fifth metatarsal stress fracture is defined as a stress fracture in the zone of the proximal fifth metatarsal immediately distal to the Jones fracture's anatomic area [4]. The mechanism of this injury is believed to be a repetitive load applied under the metatarsal head over a relatively short time, resulting in an overuse phenomenon.…”

Section: Introductionmentioning

confidence: 99%

“…are distinguished by differences in anatomic location and natural history [4,11,14]. According to numerous authors, a Jones fracture can be treated with 6 to 8 weeks of nonweightbearing immobilization resulting in fair to good outcomes [4,6,9,11,14,16,20].…”

Section: Introductionmentioning

confidence: 99%

“…According to numerous authors, a Jones fracture can be treated with 6 to 8 weeks of nonweightbearing immobilization resulting in fair to good outcomes [4,6,9,11,14,16,20]. Operative treatment is selected if the patient is a high-performance athlete or nonoperative treatment fails [5,11,14].…”

Section: Introductionmentioning

confidence: 99%

“…Operative treatment is selected if the patient is a high-performance athlete or nonoperative treatment fails [5,11,14]. In contrast, a proximal diaphyseal fifth metatarsal fracture may have a protracted healing time of as much as 21 months [4] and nonunion can develop in as much as 25% of nonoperatively treated cases [4,8]. Operative treatment usually is recommended for patients with a proximal diaphyseal fifth metatarsal fracture.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Distinguishing Jones and Proximal Diaphyseal Fractures of the Fifth Metatarsal

Chuckpaiwong

Queen

Easley

et al. 2008

Clin Orthop Relat Res

143

146

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Jones and proximal diaphyseal fractures of the fifth metatarsal are in close anatomic proximity and often are difficult to differentiate. We determined whether it is necessary to differentiate between these two diagnoses. Retrospectively, the two diagnoses were identified radiographically using an accepted classification scheme. Initial management is nonoperative; however, intramedullary screw fixation is performed for competitive athletes, or others with displaced fractures, or delayed union or nonunion. Outcomes were analyzed using Student's t tests, whereas nominal data were analyzed using chi square tests. Thirty-two Jones fractures and 29 proximal diaphyseal fractures were identified. All fractures healed between 4.8 and 9.8 months with a 78% to 82% patient satisfaction rate. Regardless of treatment, the clinical outcomes were not different between the two fracture locations. Shorter return to sport time was observed in operatively treated patients. Operatively treated patients with fracture site sclerosis or medullary canal obliteration on radiographs had lower satisfaction and higher complication rates than patients without these changes. Based on our findings, we do not find a reason to distinguish between fractures of the fifth metatarsal in these two locations. We suggest referring to fifth metatarsal base fractures (excluding avulsions) as Jones fractures.

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Section: Methodsmentioning

confidence: 99%