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Treatment of proximal metatarsal V fractures in athletes and non-athletes

2012; BMJ; Volume: 46; Issue: 9 Linguagem: Inglês

10.1136/bjsports-2011-090389

1473-0480

Gino M. M. J. Kerkhoffs, Viktor E Versteegh, Inger N. Sierevelt, Peter Kloen, C. Niek van Dijk,

Sports injuries and prevention

Since the first publication on proximal metatarsal V fractures by Jones in 1902,1 there has been a lot of controversy about the classification and ideal treatment of the proximal metatarsal V fracture. The controversy includes mainly the different anatomical,2,–,4 radiological5 and aetiological aspects.6,–,9 A proper understanding of these different aspects of the proximal metatarsal V fracture is essential, because a right interpretation of fracture type and the appropriate treatment strategy may greatly diminish the time to return to competitive sports or activities of daily living (ADL). The purpose of this study was to evaluate the treatment strategies of the different proximal metatarsal V fractures (avulsion, Jones and stress fractures, figure 1) and their outcomes in athletes and non-athletes. Figure 1 Anatomical locations of the different types of proximal fifth metatarsal fractures. The anatomic locations of the different types of proximal fifth metatarsal fractures are visualised in the grey-coloured areas. 1) Avulsion fracture (fracture of the tuberosity of the fifth metatarsal). 2) Jones fracture (border of metaphysis and diaphysis; fracture involving the intermetatarsal joint). 3) Stress fracture (fracture in the proximal diaphysis, distal from the intermetatarsal joint). This evaluation is based on a critical overview of the current literature combined with the opinion of a group of international experts. The hypothesis of this study is that operative treatment is the most effective treatment strategy for all proximal metatarsal V fractures, besides the non-displaced avulsion fracture. ### Literature overview A literature search was performed covering …