Thomas Jefferson University, Philadelphia, PA, USA.
Foot Ankle Int. 2013 Dec;34(12):1619-23. doi: 10.1177/1071100713500656. Epub 2013 Aug 1.
Nonoperative management has been the preferred treatment for displaced oblique spiral fractures of the fifth metatarsal shaft; yet a paucity of literature supports this claim. The purpose of this investigation was to report the incidence and long-term outcome in the largest cohort of these fractures reported to date.
From 2006 through 2010, 2990 patients sustaining closed metatarsal fractures were seen and treated. Displaced, oblique, spiral fractures of the distal shaft of the fifth metatarsal were identified and follow-up was conducted. Only patients who were initially treated with nonoperative management were included. Patients were seen at 6 and 12 weeks, and a minimum 2-year follow-up was conducted. In addition, demographic information was obtained, and the Short Form-12 (SF-12) and Foot and Ankle Ability Measure (FAAM) were administered. Average follow-up was 3.5 years.
In all, 142 acute fractures were managed for an incidence of 4.8% of all metatarsal fractures. There were 117 females and 25 males, average age was 55. FAAM activities of daily living subscale scores averaged 95.5 (±5.7), while FAAM sports subscales were 92.7 (±9.1). SF-12 physical and mental scores averaged 51.4 (±4.9) and 50.3 (±4.6), respectively. There were 2 delayed unions, 1 asymptomatic nonunion treated nonoperatively, and 2 painful nonunions that required open reduction internal fixation with bone grafting.
This large cohort described the relative incidence and functional outcomes of displaced oblique fracture of shaft of the fifth metatarsal bone treated nonoperatively. Nonoperative management of these fractures resulted in excellent, long-term functional outcomes.
Level II, prospective cohort study.
对于第五跖骨骨干的移位斜螺旋骨折，非手术治疗一直是首选治疗方法；然而，很少有文献支持这一说法。本研究的目的是报告迄今为止报告的此类骨折中最大队列的发病率和长期结果。
2006 年至 2010 年，共治疗了 2990 例闭合性跖骨骨折患者。确定了第五跖骨远端骨干的移位、斜向、螺旋骨折，并进行了随访。仅包括最初接受非手术治疗的患者。患者在 6 周和 12 周时进行随访，并进行了至少 2 年的随访。此外，还获得了人口统计学信息，并进行了简短形式 12 项（SF-12）和足部和踝关节能力测量（FAAM）。平均随访时间为 3.5 年。
共有 142 例急性骨折接受治疗，占所有跖骨骨折的 4.8%。女性 117 例，男性 25 例，平均年龄 55 岁。FAAM 日常生活活动量表评分为 95.5（±5.7），而 FAAM 运动量表评分为 92.7（±9.1）。SF-12 身体和精神评分分别为 51.4（±4.9）和 50.3（±4.6）。有 2 例延迟愈合，1 例无症状非愈合采用非手术治疗，2 例疼痛性不愈合需要切开复位内固定和植骨。
本大样本描述了第五跖骨干移位斜形骨折的相对发病率和功能结果，采用非手术治疗。这些骨折的非手术治疗可获得良好的长期功能结果。
II 级，前瞻性队列研究。
