Tension-Band Wiring for Fractures of the Fifth Metatarsal Located in the Junction of the Proximal Metaphysis and Diaphysis

Sarimo, Janne; Rantanen, Jussi; Orava, Sakari; Alanen, Jouko

doi:10.1177/0363546505281803

Cited by 66 publications

(50 citation statements)

References 12 publications

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“…Especially in high demand, young, sports active patients an operative treatment has to be favored as non-union rate in non-operative patients is signiWcantly higher [2,12,17] and secondary treated fractures need a more invasive surgical technique [18]. Alternatively to screw Wxation, Wxation with a bicortical screw in avulsion type fractures [19], and tension band wiring in small fragment fractures [20] is an option.…”

Section: Discussionmentioning

confidence: 99%

Intramedullary screw fixation in proximal fifth-metatarsal fractures in sports: clinical and biomechanical analysis

Leumann

Pagenstert

Fuhr

et al. 2008

Arch Orthop Trauma Surg

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Introduction and purpose Intramedullary screw Wxation (ISF) of proximal Wfth-metatarsal fractures is known as Wrst treatment option in young, sports active patients. No study analyzed functional and biomechanical outcome before. Hypothetically ISF leads to (1) a high bony union rate within 12 weeks, (2) normal hindfoot eversion strength, and (3) normal gait and plantar pressure distribution. Methods Fourteen out of 22 patients were available for follow-up with an average follow-up of 42 months; clinical and radiological follow-up, and biomechanical evaluation by isometric muscular strength measurement (inversion, eversion strength) and dynamic pedobarography, comparing to the non-aVected contralateral foot. Level of signiWcance: 0.05. Results Subjective result: Excellent or good result in 14 patients, none fair or poor. AOFAS midfoot score: 100 points in 13 patients and 87 points in 1 patient. The same sports activity level (0-4) was reached in 13 out of 14 patients. Radiologic examination: consolidation after 6 weeks in 9 patients and after 12 weeks in another 4 patients, one partial union. Average maximal eversion strength 59 N (ratio to the contralateral foot: 0.92, not signiWcant). Dynamic pedobarography showed ratios of 0.99-1.01 to the contralateral side for ground reaction force, ground peak time, peak pressure and contact area (not signiWcant). Interpretation A very-high patient-satisfaction, a fast bony healing and complete return to sports were documented. Muscular strength measurement and dynamic pedobarography showed complete functional rehabilitation. Therefore, ISF in proximal Wfth-metatarsal fractures can be recommended as a secure procedure.

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Section: Discussionmentioning

confidence: 99%

Intramedullary screw fixation in proximal fifth-metatarsal fractures in sports: clinical and biomechanical analysis

Leumann

Pagenstert

Fuhr

et al. 2008

Arch Orthop Trauma Surg

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“…En algunos casos el cerclaje con alambre puede ser favorable si hay pequeños fragmentos en la fractura que no se puedan fijar con el tornillo intramedular 33 . Sarimo et al (2006) trataron 27 pacientes con fractura de Jones con cerclaje, obteniendo muy buenos resultados 34 . Los pacientes comenzaron a soportar peso a las tres semanas y el tiempo medio de consolidación del hueso fue de 12,8 semanas 34,35 .…”

Section: Tratamiento Quirúrgicounclassified

“…Sarimo et al (2006) trataron 27 pacientes con fractura de Jones con cerclaje, obteniendo muy buenos resultados 34 . Los pacientes comenzaron a soportar peso a las tres semanas y el tiempo medio de consolidación del hueso fue de 12,8 semanas 34,35 . El quinto metatarsiano tiene una curvatura lateral y su morfología es variable, por lo que es importante elegir el tipo de tornillo adecuado para cada paciente 35 .…”

Section: Tratamiento Quirúrgicounclassified

Fractura de Jones, ¿Tratamiento quirúrgico o tratamiento conservador?

López

2018

Rev. Int. Cienc. Podol.

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Resumen. La fractura de Jones se define como una fractura transversal localizada en la unión de la diáfisis con la metáfisis proximal en el quinto metatarsiano y es una de las lesiones más comunes que aparecen en el pie. Es una zona pobremente vascularizada, lo que conlleva altas tasas de no unión de la fractura. Se diagnostica con un exploración clínica, asociada a pruebas radiológicas, siendo necesarias tres proyecciones: lateral, antero-posterior y una oblicua de 45º. Hay distintas clasificaciones como son la de Torg et al. y Dameron et al., que nos ayudan a establecer un tratamiento, en función de la localización de la fractura y su evolución radiológica. El objetivo de este trabajo es realizar una revisión en la literatura científica para valorar las diferencias en los resultados entre el tratamiento quirúrgico y tratamiento conservador, en relación al tiempo de unión ósea y las posibles complicaciones, determinando así cual es el tratamiento óptimo para estas fracturas. Se llega a la conclusión de que el tratamiento conservador es una opción viable, pero conlleva mayores tasas de no unión y mayor tiempo de retorno a la actividad física que el tratamiento quirúrgico, aunque este puede llevar a una serie de complicaciones tales como la lesión del nervio sural o una posible fractura iatrogénica del metatarsiano. El tratamiento quirúrgico, que consiste mediante la fijación con un tornillo intramedular, tiene menor tiempo de reincorporación a la actividad habitual y mayores tasas de consolidación ósea por lo que será de primera elección en deportistas. Palabras clave: fractura de jones; tratamiento quirúrgico; tratamiento conservador.[en] Jones Fracture. Surgical treatment or conservative treatment?Abstract. Jones' fracture is defined as a transverse fracture located at the junction of the diaphysis with the proximal metaphysis in the fifth metatarsal and is one of the most common lesions that appear in the foot. It's a poorly vascularized area, which leads to high rates of non-union of the fractures. It is diagnosed with a clinical examination, associated with radiological tests, three projections are necessary: lateral, antero-posterior and an oblique of 45º. There are different classifications such as Torg et al. and Dameron et al., which help us to establish a treatment, depending on the location of the fracture and its radiological evolution. The objective of this study is to perform a review in the scientific literature to evaluate the differences in the results between surgical treatment and conservative treatment, in relation to the time of union and the possible complications, thus determining which is the optimal treatment for these fractures. We conclude that conservative treatment is a viable option, but it leads to higher rates of non-union and greater time to return to physical activity than surgical treatment, although this may lead to a series of complications such as injury Sural nerve or a possible iatrogenic fracture of the metatarsal. The surgical treatment, which consists of the fixation wi...

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“…11 Two recent studies of Porter et al 14 14 suggests that cannulated screw fixation offers predictably safe union and a very satisfying mean return to sports time (7.5 weeks), which is in complete accordance with the results of previous studies defending cannulated screw fixation. 13 The study by Sarimo et al, 15 besides being the only published follow-up study with tension band technique, offers another alternative for successfully treating nonunions.…”

Section: Historical Perspectivementioning

confidence: 99%

Fixation of Proximal Fifth Metatarsal Fractures

Tsaknis

Leumann

Valderrábano

et al. 2008

Techniques in Foot &Amp; Ankle Surgery

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In athletes or in high-demand patients, requiring return to preinjury physical activity status as soon as possible, fixation of proximal fifth metatarsal fractures using intramedullary cannulated screw techniques is a safe and efficient management alternative. Appropriate screw diameter and length, corresponding to the patient`s stature, metatarsal dimensions, and shaft curvature, must be chosen. Optimal guide pin insertion under fluoroscopic control is mandatory. Postoperative management and fixation protection should be individualized. Under these conditions, quick union is predictably achieved with very low complication rates and satisfactory mean time of return to preinjury activity levels.

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Tension-Band Wiring for Fractures of the Fifth Metatarsal Located in the Junction of the Proximal Metaphysis and Diaphysis

Abstract: The tension-band wire technique seems to give good results in the treatment of proximal metaphysial/diaphysial fractures of the fifth metatarsal in cases of primary unsuccessful nonoperative treatment or primary unsuccessful intramedullary screw fixation.

Cited by 66 publications

References 12 publications

Intramedullary screw fixation in proximal fifth-metatarsal fractures in sports: clinical and biomechanical analysis

Intramedullary screw fixation in proximal fifth-metatarsal fractures in sports: clinical and biomechanical analysis

Fractura de Jones, ¿Tratamiento quirúrgico o tratamiento conservador?

Fixation of Proximal Fifth Metatarsal Fractures

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