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. 2024 May;34(4):2171-2177.
doi: 10.1007/s00590-024-03921-x. Epub 2024 Apr 3.

Functional outcome and risk of non-union for 5th metatarsal base fractures

Ethan Toner  1 , Philip McCaughey  2 , Conor Peace  2 , Roslyn Cassidy  3 , Leeann Bryce  3 , Owen Diamond  2
Affiliations

Functional outcome and risk of non-union for 5th metatarsal base fractures

Ethan Toner et al. Eur J Orthop Surg Traumatol. 2024 May.

Abstract

Objectives: Treatment of 5th metatarsal fractures via direct discharge from virtual fracture clinic (VFC) has become common practice in the NHS. We aim to assess the functional outcome and incidence of non-union in a series of 5th metatarsal base fractures, exposed to 1-year of follow-up.

Methods: 194 patients who sustained a fracture between the period February 2019 to April 2020 were included, referred via the VFC pathway. Radiographs were reviewed to classify in which zone, the fracture occurred along with union on subsequent follow-up. Telephone follow-up was used to measure patient functional outcomes (EQ-5D & FAAM survey) and satisfaction with the VFC service.

Results: Off 194 patients, 53 (27.3%) had zone 1, 99 (51%) had zone 2, and 42 (21.6%) had zone 3 fractures. 80 were discharged directly from VFC, with 114 patients being offered at least one face to face clinic follow-up. Six (3.1%) patients had clinical and radiological evidence of non-union; 4 in zone 2, and 2 in zone 3. No zone 1 injuries were identified as a non-union. Only 2 patients had surgery, 1 of which was for symptomatic non-union. Of the 6 non-union patients, 1 had surgery, 4 did not wish to have surgery and the final non-union patient was deemed unsuitable for surgery.

Conclusion: The VFC is an effective way of managing 5th metatarsal fractures, with high patient satisfaction. Conservative management has excellent outcomes, with a low percentage of zone 2 and 3 injuries developing a symptomatic non-union. Functional outcome surveys provide further reassurance.

Keywords: 5th metatarsal; Foot and ankle trauma; Non-union; Virtual fracture clinic.

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References

    1. Kane JM, Sandrowski K, Saffel H, Albanese A, Raikin SM, Pedowitz DI (2015) Epidemiology of fifth metatarsal fracture. Foot Ankle Spec 8(5):354–359. https://doi.org/10.1177/1938640015569768 . (Epub 2015 Feb 9 PMID: 25666689) - DOI - PubMed
    1. Vardy J, Rymaszewski L, Begbie K, Anthony I, Chekroud M, Clark K et al (2013) Fracture pathway redesign improves emergency department efficiency. Emer Med J 30(876):2–876. https://doi.org/10.1136/emermed-2013-203113.25 - DOI
    1. Jenkins P, Gilmour A, Murray O, Anthony I, Nugent MP, Ireland A et al (2014) The Glasgow fracture pathway: a virtual clinic. BJJ News 2:22–24
    1. Lawrence SJ, Botte MJ (1993) Jones’ fractures and related fractures of the proximal fifth metatarsal. Foot Ankle 14(6):358–365. https://doi.org/10.1177/107110079301400610 . (PMID: 8406253) - DOI - PubMed
    1. Ferguson KB, McGlynn J, Jenkins P, Madeley NJ, Kumar CS, Rymaszewski L (2015) Fifth metatarsal fractures—is routine follow-up necessary? Injury 46:1664–1668. https://doi.org/10.1016/j.injury.2015.05.041 . (Epub 2015 May 27 PMID: 26052051) - DOI - PubMed

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