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Fractures: Bone Repair01:27

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New Classification for Pediatric Proximal Fifth Metatarsal Fractures.

Hannah A Lee1, Morgan G Batley1, Arielle Krakow1

  • 1Department of Orthopaedics, The Children's Hospital of Philadelphia, PA.

The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons
|December 5, 2023
PubMed
Summary
This summary is machine-generated.

Pediatric proximal fifth metatarsal fractures heal fastest when classified as apophyseal and slowest as diaphyseal. This study identifies key factors influencing healing time in children with these common foot fractures.

Keywords:
anklechildrenfootsportstrauma

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Area of Science:

  • Orthopedic surgery
  • Pediatric orthopedics
  • Sports medicine

Background:

  • Proximal fifth metatarsal fractures are common in children but current classifications inadequately predict outcomes.
  • Identifying factors associated with healing is crucial for effective management.

Purpose of the Study:

  • To identify factors associated with healing in pediatric proximal fifth metatarsal fractures.
  • To evaluate the efficacy of different fracture classification systems in predicting healing times.

Main Methods:

  • Retrospective cohort study of 305 pediatric patients with proximal fifth metatarsal fractures.
  • Fractures classified by location, alignment, displacement, and completion, then by category: apophyseal, metaphyseal (intra-articular/extra-articular), and diaphyseal.
  • Healing times analyzed using ANOVA and linear regression, considering clinical symptoms, immobilization, return to sports, and radiographic evidence.

Main Results:

  • Fracture location significantly affected immobilization and return-to-sport times.
  • Apophyseal fractures healed fastest; diaphyseal fractures took the longest.
  • Older age correlated with slightly faster symptom resolution; gender and BMI did not impact healing.

Conclusions:

  • Classifying proximal fifth metatarsal fractures as apophyseal, metaphyseal, or diaphyseal is the most accurate and useful system for pediatric cases.
  • This study provides a robust standard for nonoperative management, useful for comparison with surgical interventions.