FRACTURES OF THE 5TH METATARSAL - ANALYSIS OF A FRACTURE REGISTRY

To understand better the natural history of fractures of the fifth met atarsal, a fracture registry was established consisting of patients wh o had acute fractures of the fifth metatarsal. The first 100 patients were studied to develop data on the natural history of injuries to thi s bone, and on the results of standard treatment for those injuries. I n this study, 3 fracture subtypes were identified: avulsion, true Jone s' fracture, and shaft/neck fracture. Avulsion fractures healed withou t immobilization, usually in 4 weeks, Shaft/neck fractures healed in p laster casts with weight bearing as tolerated in 4 to 6 weeks. True Jo nes' fractures required a prolonged time to heal when treated with 8 w eeks of nonweight bearing and then weight bearing as tolerated in a ca st. This method was, however, successful in 72% of patients (average t ime until union, 21.2 weeks). For the 7 patients in whom conservative treatment failed, surgical fixation at an average of 25 weeks after in jury reliably achieved bony union in half the time required with cast treatment. This low-risk procedure met with higher patient satisfactio n than prolonged casting.