Zone 2 Fifth Metatarsal Fractures Treated Nonoperatively Have Similar Time to Healing to Those Treated Operatively

Area of Science:

• Orthopedic surgery
• Traumatology
• Radiology

Background:

• Zone 2 proximal fifth metatarsal fractures are common injuries.
• Treatment decisions often involve operative versus nonoperative approaches.
• Understanding healing rates and times is crucial for patient outcomes.

Purpose of the Study:

• To quantify union rates and healing times for Zone 2 fifth metatarsal fractures.
• To compare operative versus nonoperative treatment outcomes.
• To evaluate clinical and radiographic healing in proximal fifth metatarsal fractures.

Main Methods:

• Retrospective cohort study at an Academic Level I Trauma Center.
• Included patients with Zone 2 fifth metatarsal fractures (December 2012 - April 2022).
• Compared nonunion rates, time to clinical healing, and time to radiographic healing between operative and nonoperative groups.

Main Results:

• 499 patients included: 95.2% nonoperative, 4.8% operative.
• No significant difference in nonunion rates (6.1% nonoperative vs. 3.8% operative).
• No significant difference in time to clinical healing (9.9 weeks vs. 15.4 weeks) or radiographic healing (18.7 weeks vs. 18.5 weeks).

Conclusions:

• Nonoperative management is a successful treatment for Zone 2 fifth metatarsal base fractures.
• Operative treatment did not demonstrate significantly faster clinical or radiographic healing.
• These findings support nonoperative management as a primary treatment strategy.