Foot and Ankle Service, KT Lee's Orthopedic Hospital, Seoul, Korea.
Foot Ankle Int. 2013 May;34(5):691-6. doi: 10.1177/1071100713475349. Epub 2013 Feb 4.
There have been diverse results even in same Torg type of fifth metatarsal stress fractures.
Eighty-six cases with a fifth metatarsal stress fracture that were treated with modified tension band wiring from January 2003 to May 2009 were evaluated retrospectively. Each case was classified according to Torg's classification and a new classification. Using the new proposed classification, cases were subdivided into complete fracture and incomplete fracture. The cases of incomplete fracture were subdivided based on presence or absence of plantar gap more than 1 mm. After surgery, bone union was determined by CT. Statistical analysis of the Torg classification and time for bone union as well as the proposed new classification and time for bone union was performed.
There was a significant difference in the time for bone union among the three Torg types (P = 0.004). The mean time for bone union in group A (complete fracture, n = 32) was 67.5 ± 28.8, and it was 103.2 ± 47.7 for group B (incomplete fracture, n = 54). There was a significant difference in time for bone union between them (P < 0.001). The mean time for bone union in group B1 (incomplete fracture, plantar gap less than 1 mm, n = 16) was 73.9 ± 26.7, and it was 115.5 ± 45.4 for group B2 (incomplete fracture, plantar gap 1 mm or more, n = 38). There was a significant difference in time for bone union between them (P < 0.001).
The results of this study suggest that the classification incorporating the plantar gap might be used for classification of fifth metatarsal stress fractures.
Level III, retrospective comparative series.
即使是同种 Torg 类型的第五跖骨应力性骨折，结果也存在差异。
回顾性分析 2003 年 1 月至 2009 年 5 月采用改良张力带钢丝固定治疗的 86 例第五跖骨应力性骨折患者。根据 Torg 分型和新的分型对每一病例进行分类。使用新的分型，将不完全骨折病例分为完全骨折和不完全骨折。不完全骨折病例根据是否存在超过 1mm 的足底间隙进一步细分。术后通过 CT 确定骨愈合情况。对 Torg 分型和骨愈合时间以及新提出的分型和骨愈合时间进行统计学分析。
三种 Torg 类型的骨愈合时间有显著差异（P = 0.004）。A 组（完全骨折，n = 32）的平均骨愈合时间为 67.5 ± 28.8，B 组（不完全骨折，n = 54）为 103.2 ± 47.7。两组间有显著差异（P < 0.001）。B1 组（不完全骨折，足底间隙小于 1mm，n = 16）的平均骨愈合时间为 73.9 ± 26.7，B2 组（不完全骨折，足底间隙 1mm 或更大，n = 38）为 115.5 ± 45.4。两组间有显著差异（P < 0.001）。
本研究结果表明，包含足底间隙的分型可能用于第五跖骨应力性骨折的分型。
III 级，回顾性比较系列。
