Metatarsal Fractures

2017 ◽  
pp. 393-398
Author(s):  
Megan R. Wolf ◽  
Lauren E. Geaney
Keyword(s):  
2011 ◽  
Author(s):  
Toby O Smith ◽  
Tressa D Amirthanayagam ◽  
Allan B Clark ◽  
Caroline B Hing
Keyword(s):  

2021 ◽  
Vol 6 (1) ◽  
pp. 247301142097570
Author(s):  
Mossub Qatu ◽  
George Borrelli ◽  
Christopher Traynor ◽  
Joseph Weistroffer ◽  
James Jastifer

Background: The intermetatarsal joint between the fourth and fifth metatarsals (4-5 IM) is important in defining fifth metatarsal fractures. The purpose of the current study was to quantify this joint in order to determine the mean cartilage area, the percentage of the articulation that is cartilage, and to give the clinician data to help understand the joint anatomy as it relates to fifth metatarsal fracture classification. Methods: Twenty cadaver 4-5 IM joints were dissected. Digital images were taken and the articular cartilage was quantified by calibrated digital imaging software. Results: For the lateral fourth proximal intermetatarsal articulation, the mean area of articulation was 188 ± 49 mm2, with 49% of the area composed of articular cartilage. The shape of the articular cartilage had 3 variations: triangular, oval, and square. A triangular variant was the most common (80%, 16 of 20 specimens). For the medial fifth proximal intermetatarsal articulation, the mean area of articulation was 143 ± 30 mm2, with 48% of the joint surface being composed of articular cartilage. The shape of the articular surface was oval or triangular. An oval variant was the most common (75%, 15 of 20 specimens). Conclusion: This study supports the notion that the 4-5 IM joint is not completely articular and has both fibrous and cartilaginous components. Clinical Relevance: The clinical significance of this study is that it quantifies the articular surface area and shape. This information may be useful in understanding fifth metatarsal fracture extension into the articular surface and to inform implant design and also help guide surgeons intraoperatively in order to minimize articular damage.


2017 ◽  
Vol 39 (2) ◽  
pp. 250-258 ◽  
Author(s):  
David A. Porter

Fifth metatarsal fractures, otherwise known as “Jones” fractures, occur commonly in athletes and nonathletes alike. While recent occurrence in the popular elite athlete has increased public knowledge and interest in the fracture, this injury is common at all levels of sport. This review will focus on all three types of Jones fractures. The current standard for treatment is operative intervention with intramedullary screw fixation. Athletes typically report an acute episode of lateral foot pain, described as an ache. Radiographic imaging with multiple views of the weightbearing injured foot are needed to confirm diagnosis. If these images are inconclusive, further magnetic resonance imaging (MRI) or computed tomography (CT) is used. Nonoperative treatment is not commonly used as the sole treatment, except when following reinjury of a stable screw fixation. While screw selection is still controversial, operative treatment with intramedullary screw fixation is the standard approach. Technical tips on screw displacement are provided for Torg (types I, II, III) fractures, cavovarus foot fractures, recurrent fractures, revision surgery, occult fractures/high-grade stress reactions, and Jones’ variants. Excellent clinical outcomes can be expected in 80% to 100% of patients when using the intramedullary screw fixation to “fit and fill” the medullary canal with threads across the fracture site. Most studies show the timing for return to sports with optimal healing to be seven to twelve weeks after fixation. Level of Evidence: Level V, expert opinion.


The Surgeon ◽  
2009 ◽  
Vol 7 (2) ◽  
pp. 86-88 ◽  
Author(s):  
W.M.V. Shuen ◽  
C. Boulton ◽  
M.E. Batt ◽  
C. Moran
Keyword(s):  

1973 ◽  
Vol 13 (6) ◽  
pp. 572
Author(s):  
A. Reichelt ◽  
G. Derkmann
Keyword(s):  

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Ali Hosseini ◽  
Pim Van Dijk ◽  
Sofie Breuking ◽  
Bryan Vopat ◽  
Daniel Guss ◽  
...  

Category: Midfoot/Forefoot Introduction/Purpose: Proximal fifth metatarsal fractures (PFMF) are among the most common fractures in the foot and can be categorized into three fracture zones [1]. To investigate the fracture mechanism of PFMF in different zones, a better understanding of the anatomy of the bone and its surrounding soft tissues is required. Both the plantar fascia (PF) and the peroneus brevis (PB) tendon insertions are at the base of the fifth metatarsal, and may contribute to the pathophysiology of PFMF. However, the role of the PB and PF insertions in the pathogenesis of PFMF remains unclear. The purpose of this study was to accurately define the footprint of the PB and PF insertions of the base of the 5th metatarsal in relation to the different zones of PFMF. Methods: 21 cadaveric fifth metatarsal bones were harvested from cadaveric feet. All bones were freed of any remaining soft tissue adherence, except for the PB and the PF insertions. Three reference screws with a diameter of 1 mm were placed and secured on each bone with 2 screws distally and 1 screw proximally for registration. All bones were CT scanned to create a 3D bone reconstruction. Next, the insertions of the PB and PF and the reference screws of each bone were digitized and then mapped to its corresponding 3D bone model. In order to describe the three different fracture zones of the 5th metatarsal, an established coordinate system was made for each bone to simulate separate fracture zones (Figure a) based on Lawrence guideline [1]. The shape, location and surface areas of both insertions and their relation to the different fractures zones were determined (Figure b). Results: The insertion of the PB was oval shaped and located on the dorsal side of the base, with a mean surface area of 88.1 ± 46.4 mm2. The PF was oval shaped and situated around the tip of tuberosity, with a mean surface area of 150.7±53.5 mm2. The PB insertion was present in zone 1 fractures in 100% (21/21) of the 5th metatarsal models and 29% (6/21) of the models for zone 2 fractures. The PF insertion was involved in 100% (21/21) of the 5th metatarsal models for zone 1 fractures and 43% (9/21) of the models for zone 2 fractures. Conclusion: Results of this study demonstrate that the insertion of both the PB and PF are involved in all zone 1 PFMF and a significant percentage of zone 2 PFMF. The location of tendon insertions affect the forces exerted on the bone, which may indicate a relation of the insertions of both the PB and the PF with the fracture mechanism of many zone 1 and 2 PFMF. Moreover, in the treatment of these fractures, care should be taken to maintain or restore the anatomy of these insertions to maximize functional outcomes.


2006 ◽  
Vol 5 (4) ◽  
pp. 230-238 ◽  
Author(s):  
John G. Anderson ◽  
Donald R. Bohay
Keyword(s):  

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