The Clinical Outcomes of Operative Treatment versus Conservative Treatment for 5th Metatarsal Diaphyseal Fractures

Document Type : Original Article

Authors

Orthopedic Surgery, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

Abstract

Background: Fifth metatarsal fractures are one of the most common foot fractures. The incidence of fifth metatarsal fractures is reported at 6.7 fractures for every 10,000 people. The fracture of the proximal fifth metatarsal is not only owing to the direct injuries in this area, but also to the indirect injuries with plantar flexion. These fractures can lead to a serious incidence rate, especially in athletes. During the time of competition, the time is obviously shortened, and refracture, sometimes it cannot resume sports.
Aim and objectives: To assess and evaluate the efficacy of conservative and surgical approaches to treating 5th metatarsal diaphyseal fractures.
Patients and methods: At Al-Azhar University's Orthopedic Surgery Department, Faculty of Medicine, a randomized prospective comparative study was carried out. We enlisted the help of patients from Dessoq General Hospital, El-Hussein and Sayed Galal Hospitals, and their Outpatient Clinics and Emergency Units. It was performed at a period started from March 2023 till September 2024.
Results: In terms of ankle range of motion (ROM), partial weight bearing, complete weight bearing, and time to bone union, the conservative group significantly outperformed the surgical group. In terms of delayed union and malunion, the conservative group had a statistically significantly higher rate than the surgical group. The surgical group had a statistically significant rise in the foot and ankle disability score compared to the conservative group.
Conclusion: Surgical treatment generally offers superior outcomes in terms of faster recovery, reduced complications, and overall lower disability. These findings suggest that surgical intervention is often preferable for achieving quicker and more reliable recovery, although treatment decisions should be individualized based on patient-specific factors and desired outcomes.

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