Fractures of the fifth metatarsal in basketball players

A prospective nonrandomized study was made of 17 basketball players with fr actures of the proximal third of the shaft of the fifth metatarsal. Eight h ad acute fractures, which were treated with a cast without weight-bearing, and the other nine had stress fractures for which percutaneous compression screwing was initially used. In the first group, union was obtained in four cases in an average of 9 weeks, with resumption of sport by 12 weeks. Thre e had a good outcome and the fourth was fair. The other four cases, which h ad not healed after 12 weeks of immobilization, were subsequently treated u sing compression screws. Resumption of sport was achieved 20-24 weeks after the fracture. Two of these had a good result; in the other two the results were fair. Of the nine patients with stress fractures in which a screw was inserted, all healed between 8 and 14 weeks and returned to sport within 7 -12 weeks. Seven had a good result and the other two only fair. There was o ne intraoperative complication, but no postoperative complications, such as nonunion or refracture, were observed. Even if the non-operative treatment is able to provide a good result, immobilization without weight-bearing do es not guarantee healing. In this series, percutaneous screw fixation was a ble to achieve successful healing in a short period of time. Thus, this pro cedure seems to be preferable for primary treatment of this lesion in athle tes.