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Subject Area

Orthopedic Surgery

Article Type

Original Study

Abstract

Background Tuberosity-avulsion fracture is the most common fracture of proximal fifth metatarsal accounting for 94% of fractures of the fifth metatarsal. Objective To compare between the results of conservative and minimally invasive surgical management of displaced avulsion fractures of the fifth metatarsal base (zone one) in adults. Patients and methods A prospective comparative study was conducted on 40 patients with avulsion fractures of the base fifth metatarsal bone at the Department of Orthopedics and Trauma Surgery in Menoufia University and Qabbary Hospital in Alexandria from September 2018 to 2021. Results A total of 40 patients with avulsion fractures of the base fifth metatarsal bone, their age ranged from 19 to 60 years with mean 36.65 ± 18.49 years. Among the cast group, the mean visual analog pain scale score declined from 7.27 ± 0.8 to 2.93 ± 1.1, then 0.53 ± 0.8, and finally 0. While, among the surgery group, the visual analog pain scale score declined from 7.4 ± 0.9 to 0.47 ± 0.7 and then finally 0, with a statistically significant difference between cast and surgery groups (P < 0.05). Time till fracture radiological union and till return to full activity was significantly decreased among surgery group (4.8 ± 1 and 6.87 ± 0.9 weeks) than cast group (6.67 ± 1.1 and 8.93 ± 1.2), respectively, with P value less than 0.001. Conclusion We concluded that interfragmentary screw fixation is a reliable, easy, and safe method of fixation for avulsion-base fifth metatarsal, which allows earlier union rate, earlier return to weight-bearing, and earlier return to normal activity in comparison with cast management that has longer union rate time.

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