Abstract
Metaphyseal and proximal diaphyseal fractures of the lateral column metatarsals can
have problems with healing. In particular, those involving the fifth metatarsal have
been associated with a high nonunion rate with nonoperative treatment. Although intramedullary
screw fixation results in a high union rate, delayed healing and complications can
occur. We describe an innovative technique to treat both acute and chronic injuries
involving the metatarsal base from the metaphysis to the proximal diaphyseal bone
of the fourth and fifth metatarsals. The surgical technique involves evacuation of
sclerotic bone at the fracture site, packing the fracture site with compact cancellous
bone, and plate fixation. In our preliminary results, 4 patients displayed 100% radiographic
union at a mean of 4.75 (range 4 to 6) weeks with no incidence of refracture, at a
mean follow-up point of 3.5 (range 1 to 5) years. The early results with our small
series suggest that this technique is a useful treatment choice for metaphyseal and
proximal diaphyseal fractures of the fourth and fifth metatarsals.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: June 13, 2017
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: A.S. received royalties and honoraria from Trimed, Inc.
Identification
Copyright
© 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.
