Kavanaugh J H, Brower T D, Mann R V
J Bone Joint Surg Am. 1978 Sep;60(6):776-82.
Twenty-two patients with twenty-three fractures of the proximal part of the diaphysis of the fifth metatarsal, an injury originally described by Jones, are reported. The average follow-up was 3.5 years. Delayed union occurred in twelve (66.7 per cent) of eighteen patients treated conservatively. Four patients were operated on within two weeks of injury. The clinical picture in nine of the twenty-two patients suggested that the injury was a stress fracture. Force-platform analysis in eleven cases confirmed that the injury results from vertical and mediolateral forces concentrated over the fifth metatarsal and that it is not caused by inversion. Thirteen of the twenty-three fractures were in young athletes, often occurring during training and causing significant disability. In this group of patients, and in a select number of recreational athletes and non-athletes with delayed union, intramedullary screw fixation of the fracture is advised.
报告了22例第五跖骨干近端23处骨折患者，该损伤最初由琼斯描述。平均随访时间为3.5年。18例保守治疗患者中有12例（66.7%）发生延迟愈合。4例患者在受伤后两周内接受了手术。22例患者中有9例的临床表现提示该损伤为应力性骨折。11例患者的测力平台分析证实，该损伤是由集中在第五跖骨上的垂直和内外侧力引起的，而非内翻所致。23处骨折中有13处发生在年轻运动员身上，常在训练期间发生并导致明显残疾。对于这组患者，以及一些延迟愈合的休闲运动员和非运动员，建议采用髓内螺钉固定骨折。
