| Intramedullary screw fixation in proximal fifth-metatarsal fractures in sports: clinical and biomechanical analysis. | |
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MedLine Citation:
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PMID: 18677492 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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André Leumann; Geert Pagenstert; Peter Fuhr; Beat Hintermann; Victor Valderrabano |
Publication Detail:
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Type: Evaluation Studies; Journal Article Date: 2008-08-02 |
Journal Detail:
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Title: Archives of orthopaedic and trauma surgery Volume: 128 ISSN: 1434-3916 ISO Abbreviation: Arch Orthop Trauma Surg Publication Date: 2008 Dec |
Date Detail:
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Created Date: 2008-10-30 Completed Date: 2009-01-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9011043 Medline TA: Arch Orthop Trauma Surg Country: Germany |
Other Details:
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Languages: eng Pagination: 1425-30 Citation Subset: IM |
Affiliation:
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Orthopaedic Department, Lower Extremity Orthopaedics, University Hospital of Basel, Spitalstr. 21, 4031 Basel, Switzerland. leumanna@uhbs.ch |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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
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