Summary of the Patient Data Following the Operation We recorded the preoperative displacement and postoperative reduction following bicortical screw fixation in all the patients ( Tables 1 and 2). Twenty three patients with 23 fractures (17 in zone II and 6 in zone I) were operated on using bicortical screw fixation at a mean of 6.96 ± 5.39 days (range, 1 to 23 days) after injury. Fifteen right feet and seven left feet were involved. There were 12 males and 11 females (median age, 44.3 years range, 16 to 74 years). The articulations of the fifth tarsometatarsal joint were involved. In six of the zone I fractures, all the fractures were intraarticularily displaced more than 2 mm. The mechanism of injury was inversion of the ankle and adduction of the forefoot, which was twisting and falling in 20 patients and sports injury in 3 patients. ![]() ![]() The displaced zone III diaphyseal fractures were treated with intramedullary screw fixation. The chronic, open or severely comminuted fractures were treated with open reduction and internal fixation with screws or wires. Our inclusion criteria for percutaneous bicortical screw fixation was acute, closed, not severely comminuted and more than 2 mm displaced intraarticular zone I and zone II fractures. Extraarticular zone I avulsion fractures, zone III diaphyseal stress fractures, severely comminuted fractures, pediatric fractures, open fractures and fractures that were treated by other methods of fixation were excluded. There were 23 such fractures (17 in zone II and 6 in zone I) that were treated by bicortical screw fixation. However, in the present study we included only the displaced intraarticular zone I and zone II fractures with displacement of more than 2 mm, which were treated by percutaneous bicortical screw fixation. We also evaluated the short- and long-term clinical and radiological results of the bicortical fixation of these fractures.įrom January 2003 through August 2008, a total of 84 fractures of the proximal fifth metatarsal bone were treated operatively by one orthopaedic surgeon (JSS). ![]() Therefore, the aim of this study was to evaluate the effectiveness of percutaneous bicortical screw fixation for the displaced intraarticular zone I and zone II fractures of the proximal fifth metatarsal. 6, 8 - 10) To date, no clinical study has evaluated the effectiveness of percutaneous bicortical screw fixation for these fractures. 7) Undisplaced zone I and zone II fractures usually respond well to conservative treatment however, operative fixation of the displaced zone II fractures and the displaced intraarticular zone I fractures has shown better results than conservative treatment. It is of utmost importance to distinguish between the acute fractures and the diaphyseal stress fractures for proper management. Schematic representation of the fracture zones for fifth metatarsal base fractures by Lawrence and Botte 3) (zone I, zone II, zone III) and the gray-colored area represents the zone II and intraarticular zone I fractures for surgical intervention in this study.
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