specifically palpate for a fifth metatarsal fracture.When examining a patient for a fracture of the fifth metatarsal, the examiner should There is pain-limited weight-bearing along the lateral aspect of the foot. In the case of fifth metatarsal styloid fracture, the pain and soreness is at the tuberosity of the fifth metatarsal base. Patients with a fifth metatarsal styloid fracture or a Jones fracture (proximal diaphysis) exhibit marked tenderness at the proximal fifth metatarsal, and bruising may be present. The examiner should always check for point tenderness of the metatarsal tenderness with any ankle injury. Easily missed in many cases, because the examiner focuses on the ankle injury.Sometimes caused by placement of abnormal stress.Swelling and point tenderness with an inability to bear weight along the lateral border of the foot.These result from the placement of abnormal stress on a normal bone. However, some stress fractures may appear more proximally, especially in dancers axial loads with torsion result in more proximal fractures. Stress fractures: Stress fractures of the metatarsals may occur distally at the metatarsal neck in runners.The resulting injury is more serious ( Fig. These result from laterally directed force on the forefoot with the ankle in plantar flexion (see “Radiographic Evaluation” for more information) they are caused by inversion of the foot. Jones fractures: True Jones fractures, more rare than avulsion fractures, occur at the proximal diaphysis (shaft).Avulsion fractures are transverse fractures that generally involve the tuberosity of the metatarsal base-the site of attachment of the avulsed peroneus brevis tendon. * Patients may complain of tripping or missing a curb or the rung of ladder. Avulsion fractures: These fractures have a mechanism of injury that is similar to an ankle sprain.There are basically three types of fifth metatarsal injuries. Tenderness at the base of the fifth metatarsal may be present.įractures of the foot are common and often involve the fifth metatarsal, the bone that runs from the middle of the foot to the base of the small toe ( Fig.Patients complain of pain and swelling.From our series, it is evident that most pediatric fifth metatarsal fractures behave as those found in adults and can be treated similarly. We recommend non-weight bearing casts for all angulated or displaced intra-articular injuries to avoid delays in healing and angulation. Fixation of Jones fractures in active adolescents should be considered to allow faster return to regular activities and prevent refracture. Most fractures of the fifth metatarsal in the pediatric population do well clinically after a course of walking cast, unless the fracture is an intra-articular displaced fracture type or the fracture occurs in the proximal diaphyseal area. Neck and shaft fractures did well with casting. Jones fractures had delays in healing if not treated surgically. Displaced intraarticular fractures had a significant delay in healing versus nondisplaced ones. Metatarsal neck and shaft fractures were included separately.Īpophyseal fractures did well with a short-leg walking cast for 3 to 6 weeks. Type III injuries represented Jones fracture. Type II represented tubercle fractures with intra-articular extension. The fractures were classified according to location. The purpose of our study was to identify the different types of fifth metatarsal fractures, to determine the mean time to healing, and to examine whether current adult recommendations can be extrapolated to children and adolescents.Ī total of 103 patients met the inclusion criteria. Their treatment is based on the adult literature. Fractures of the fifth metatarsal are the most common metatarsal fractures in children.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |