Publication: Comparative Study between Operative versus Non-operative Treatment for Base of Fifth Metatarsal Fractures in Young Adults
Date
2021
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
The treatment of displaced base of fifth metatarsal fracture remains controversial
regarding the conservative and operative treatment.
Objective
To investigate the therapeutic effect of operative and non-operative treatment for
base of fifth metatarsal fractures.
Method
This was retrospective comparative study performed in Civil Service Hospital,
Kathmandu, Nepal from December 2014 to November 2019. Patients were randomly
divided into two groups by computer generated technique. Group1 included 17
patients who underwent open reduction and internal fixation using tension band
wiring, whereas group 2 included 17 patients who underwent non-operative
treatment with boot cast.
Result
The AOFAS and VAS-FA scores at 3 months in operative and non-operative groups
were 89.34±2.14 versus 86.94±2.22 (p < 0.05) and 5.58±0.87 versus 3.58±0.93 (p <
0.05). Similarly, AOFAS and VAS-FA at 12 months after treatment were 90.94±2.43
versus 90.17±1.55 (p > 0.05) and 0.64±0.280.94±0.39 (p > 0.05) in operative and
non-operative groups respectively. The average time to bear full weight and return
to work were 6.82±1.13 versus 7.08±1.24 weeks (p > 0.05) and 8.76±1.20 versus
10.35±1.41 weeks ( p < 0.05) respectively. The mean of VAS score at 3months of
treatment is 5.58±0.87 for non-operative group and 3.58±0.93 for operative group
(p <0.05).
Conclusion
Operative intervention has been preferred over the non-operative treatment in young
adults or athletes with more than 3 mm displaced fifth metatarsal base fracture to
achieve anatomical reduction of fracture, hasten the recovery and rehabilitation and
to decrease the complications associated with non-operative treatment.
KEY WORDS
Comparison, Fifth metatarsal fracture, Non-operative treatment, Operative
treatment, Tension band wiring
Description
KC KM,1 Marahatta SB,1 Niroula A,1 KC A,2 Pangeni RB1
1Department of Orthopedics
Civil Service Hospital,
Minbhawan, Kathmandu, Nepal.
2Nepalese Army Institute of Health Sciences,
Sanobharyang, Kathmandu, Nepal
Keywords
omparison, Fifth metatarsal fracture, Non-operative treatment, Operative treatment, Tension band wiring