Functional outcome and risk of non-union for 5th metatarsal base fractures.

5th metatarsal Foot and ankle trauma Non-union Virtual fracture clinic

Journal

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie
ISSN: 1432-1068
Titre abrégé: Eur J Orthop Surg Traumatol
Pays: France
ID NLM: 9518037

Informations de publication

Date de publication:
03 Apr 2024
Historique:
received: 16 11 2023
accepted: 14 03 2024
medline: 4 4 2024
pubmed: 4 4 2024
entrez: 3 4 2024
Statut: aheadofprint

Résumé

Treatment of 5th metatarsal fractures via direct discharge from virtual fracture clinic (VFC) has become common practice in the NHS. We aim to assess the functional outcome and incidence of non-union in a series of 5th metatarsal base fractures, exposed to 1-year of follow-up. 194 patients who sustained a fracture between the period February 2019 to April 2020 were included, referred via the VFC pathway. Radiographs were reviewed to classify in which zone, the fracture occurred along with union on subsequent follow-up. Telephone follow-up was used to measure patient functional outcomes (EQ-5D & FAAM survey) and satisfaction with the VFC service. Off 194 patients, 53 (27.3%) had zone 1, 99 (51%) had zone 2, and 42 (21.6%) had zone 3 fractures. 80 were discharged directly from VFC, with 114 patients being offered at least one face to face clinic follow-up. Six (3.1%) patients had clinical and radiological evidence of non-union; 4 in zone 2, and 2 in zone 3. No zone 1 injuries were identified as a non-union. Only 2 patients had surgery, 1 of which was for symptomatic non-union. Of the 6 non-union patients, 1 had surgery, 4 did not wish to have surgery and the final non-union patient was deemed unsuitable for surgery. The VFC is an effective way of managing 5th metatarsal fractures, with high patient satisfaction. Conservative management has excellent outcomes, with a low percentage of zone 2 and 3 injuries developing a symptomatic non-union. Functional outcome surveys provide further reassurance.

Identifiants

pubmed: 38570341
doi: 10.1007/s00590-024-03921-x
pii: 10.1007/s00590-024-03921-x
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.

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Auteurs

Ethan Toner (E)

Department of Trauma & Orthopaedics, Royal Victoria Hospital, Belfast, BT12 6BA, UK. ethantoner@doctors.org.uk.

Philip McCaughey (P)

Department of Trauma & Orthopaedics, Royal Victoria Hospital, Belfast, BT12 6BA, UK.

Conor Peace (C)

Department of Trauma & Orthopaedics, Royal Victoria Hospital, Belfast, BT12 6BA, UK.

Roslyn Cassidy (R)

Outcomes Department, Musgrave Park Hospital, Belfast, BT9 7JB, UK.

Leeann Bryce (L)

Outcomes Department, Musgrave Park Hospital, Belfast, BT9 7JB, UK.

Owen Diamond (O)

Department of Trauma & Orthopaedics, Royal Victoria Hospital, Belfast, BT12 6BA, UK.

Classifications MeSH