Document Detail


Intramedullary screw fixation in proximal fifth-metatarsal fractures in sports: clinical and biomechanical analysis.
MedLine Citation:
PMID:  18677492     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION AND PURPOSE: Intramedullary screw fixation (ISF) of proximal fifth-metatarsal fractures is known as first treatment option in young, sports active patients. No study analyzed functional and biomechanical outcome before. Hypothetically ISF leads to (1) a high bony union rate within 12 weeks, (2) normal hindfoot eversion strength, and (3) normal gait and plantar pressure distribution. METHODS: Fourteen out of 22 patients were available for follow-up with an average follow-up of 42 months; clinical and radiological follow-up, and biomechanical evaluation by isometric muscular strength measurement (inversion, eversion strength) and dynamic pedobarography, comparing to the non-affected contralateral foot. Level of significance: 0.05. RESULTS: Subjective result: Excellent or good result in 14 patients, none fair or poor. AOFAS midfoot score: 100 points in 13 patients and 87 points in 1 patient. The same sports activity level (0-4) was reached in 13 out of 14 patients. Radiologic examination: consolidation after 6 weeks in 9 patients and after 12 weeks in another 4 patients, one partial union. Average maximal eversion strength 59 N (ratio to the contralateral foot: 0.92, not significant). Dynamic pedobarography showed ratios of 0.99-1.01 to the contralateral side for ground reaction force, ground peak time, peak pressure and contact area (not significant). INTERPRETATION: A very-high patient-satisfaction, a fast bony healing and complete return to sports were documented. Muscular strength measurement and dynamic pedobarography showed complete functional rehabilitation. Therefore, ISF in proximal fifth-metatarsal fractures can be recommended as a secure procedure.
Authors:
André Leumann; Geert Pagenstert; Peter Fuhr; Beat Hintermann; Victor Valderrabano
Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2008-08-02
Journal Detail:
Title:  Archives of orthopaedic and trauma surgery     Volume:  128     ISSN:  1434-3916     ISO Abbreviation:  Arch Orthop Trauma Surg     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-10-30     Completed Date:  2009-01-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9011043     Medline TA:  Arch Orthop Trauma Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1425-30     Citation Subset:  IM    
Affiliation:
Orthopaedic Department, Lower Extremity Orthopaedics, University Hospital of Basel, Spitalstr. 21, 4031 Basel, Switzerland. leumanna@uhbs.ch
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Athletic Injuries / radiography,  surgery*
Bone Screws*
Cohort Studies
Female
Follow-Up Studies
Fracture Fixation, Intramedullary / instrumentation*,  methods
Fracture Healing / physiology*
Fractures, Bone / radiography,  surgery*
Gait / physiology
Humans
Male
Metatarsal Bones / injuries*,  surgery
Middle Aged
Pain Measurement
Recovery of Function
Risk Assessment
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Efficacy of an aiming device for the placement of distal interlocking screws in trochanteric fixatio...
Next Document:  Nonunion of distal radius fracture and distal radioulnar joint injury: a modified Sauvé-Kapandji pr...