[Conservative therapy for metatarsal 5 basis fractures - retrospective and prospective analysis]

Approximately 30 % of all bone injuries are foot metatarsal fractures. Metatarsal V basis fractures occur most frequently. The classification is done into the tuberosity avulsion fractures, Jones fractures and stress fractures of the proximal diaphysis. The treatments of non-displaced fractures are generally conservative. The indication for surgical treatment depends on the load and the associated refracture rate. There are different types of treatment of these fractures. We present a possible approach to conservative treatments and show how different therapies affect healing of metatarsal V basis fractures and social reintegration of patients.

A retrospective study consisted of 68 patients analysed during a 9-year period, whereas for a prospective analysis 18 patients were included for a period of 3 years. The treatment was performed using either a splint, closed bandage of the ankle or special Göttinger Anklesplint bandage, with immediate pain-oriented full load in all groups. The subjective and objective treatment results were analysed accoding the Göttinger Phillips score.

In retrospect, the fracture consolidation was observed after 8.1 weeks full load-bearing was achieved after 6.3 weeks on average. In the prospective analysis, the osseous consolidation occurred after 6.2 weeks, and the full load was applied after 1.7 weeks. After 10 weeks the treatment with the Anklesplint bandage was assessed with 105 points of a maximum 110 points of the Phillips score. The Anklesplint bandage was also the cheapest option in the cost comparison.

Using the immobilisation of the metatarsal supination with the Anklesplint bandage the metatarsal V basis fractures can heal in a regular way. The functional outcome is better in comparison to the that with other treatments and it is a cost-effective treatment.