Medicina, Vol. 56 No. 3, 2020.
Izvorni znanstveni članak
https://doi.org/10.21860/medflum2020_241504
Treatment of proximal fifth metatarsal bone fractures in athletes
Mladen Japjec
orcid.org/0000-0001-9514-5154
; Klinika za kirurgiju, Klinička bolnica Merkur, Zagreb, Hrvatska
Božidar Šebečić
; Klinika za kirurgiju, Klinička bolnica Merkur, Zagreb, Hrvatska
Josip Štivičić
; Klinika za kirurgiju, Klinička bolnica Merkur, Zagreb, Hrvatska
Andrija Jurina
; Klinika za kirurgiju, Klinička bolnica Merkur, Zagreb, Hrvatska
Valentino Zlodi
; Klinika za kirurgiju, Klinička bolnica Merkur, Zagreb, Hrvatska
Ivan Bagić
; Klinika za kirurgiju, Klinička bolnica Merkur, Zagreb, Hrvatska
Tomislav Dujmović
; Klinika za kirurgiju, Klinička bolnica Merkur, Zagreb, Hrvatska
Mario Starešinić
; Klinika za kirurgiju, Klinička bolnica Merkur, Zagreb, Hrvatska
Sažetak
Aim: To compare the results of conservative and surgical treatment of fractures of the proximal fifth metatarsal (V MT) bone in the athletes. These fractures represent a great diagnostic and therapeutic challenge. They are traditionaly divided into 3 zones: tuberosity (zone I), metaphysis (zone II), and proximal diaphysis (zone III). Due to the compromised circulation, these fractures are characterized by difficult and prolonged healing that ends with the development of pseudarthrosis, especially in young and physically active individuals. Patients and Methods: During the 13-year period in University Hospital Merkur 61 athletes with a total of 65 fractures of V MT bones in zone II and III were treated. All other patients were excluded from this study. The patients were divided into 2 groups: Group 1 - operatively treated and Group 2 - conservatively treated fractures.There were 50 (77%) fractures in Group 1 and 15 (23%) in Group 2. At the beginning of the study, a maleolar screw was used for osteosynthesis but due to complications it was later replaced by a stronger intramedullary screw. Treatment results were followed by radiological and clinical examination and evaluated by Modified Foot score (MFS). Results: The follow-up period averaged 12 months. In the Group 1 most fractures healed within 8 weeks. Prolonged healing were present in 7 (14%) fractures. In the later rehabilitation period 3 (6%) patients had refracture which was resolved by reopereting and installing a stronger screw.In the Group2, 7 (46%) fractures did not heal over a 6-month period and 5 (33%) of them underwent surgery. Finally, all operated fractures were healed. According to MFS, the Group1 had a significantly better result. Conclusion: Good diagnosis and classification of fractures, as well as surgical treatment of fractures of the metaphysis and proximal diaphysis, guarantee rapid fracture healing and early return to full sport activity.
Ključne riječi
athletes; metatarsal bones; stress fracture
Hrčak ID:
241504
URI
Datum izdavanja:
1.9.2020.
Posjeta: 6.069 *