[Para-basal metatarsal V fracture: conservative functional treatment]

Fractures of the fifth metatarsal bone, mostly avulsion fractures that result from forced inversion of the plantar foot, are relatively common. There are two distinct types of fracture that involve the proximal portion of the fifth metatarsal bone. The first type is the proximal diaphyseal fracture, the so-called Jones fracture, and the second type involves the area of the metatarsal tuberosity. They are usually not displaced or only slightly displaced. The standard treatment is a below-the-knee walking cast Osteosynthesis for fractures of the fifth metatarsal bone is indicated only in cases where significant displacement cannot be corrected by closed reduction. At the Department of Traumatology in the Städtische Klinikum Braunschweig. 51 patients (32 male, 19 female) with an avulsion fracture of the proximal diaphyseal portion or a Jones fracture of the fifth metatarsal bone were treated functionally with a brace (Caligamed II). The average displacement was 1.4 mm (range 0.8-4.0 mm). In each case the fracture was treated for 2-3 days in a short leg cast and additional antiphlogistic medication was applied. After edema had been reduced, every patient was fitted with a carefully adapted Caligamed II brace, and this was followed by intense mobilization and walking therapy. The average follow-up in this study was 14.2 +/- 1.8 month. In this protocol the patients were examined at our clinic during the first week after trauma in order to check the brace again, again after 5-6 weeks for X-rays and to remove the brace, and for a final check-up after 12 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)