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Kim, Kim, Lee, Kim, and Rhee: Surgical Treatment of the Fifth Metatarsal Base Fracture Using Multiple Kirschner Wires
Original Article

J Korean Foot Ankle Soc 2014;18(1):24-28.

Published online: 10 March 2014

DOI: https://doi.org/10.14193/jkfas.2014.18.1.24

Surgical Treatment of the Fifth Metatarsal Base Fracture Using Multiple Kirschner Wires

Jihyeung Kim, Jang Woo Kim, Jeong Ik Lee, Sang Kil Kim, Seung Hwan Rhee

Department of Orthopaedic Surgery, Seoul National University Boramae Medical Center, Seoul, Korea

Corresponding Author: Jihyeung Kim Department of Orthopaedic Surgery, Seoul National University Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 156-849, Korea Tel: 82-2-870-2319, Fax: 82-2-831-0714, E-mail: kjh12344@hanmail.net

Received 6 January 2014       Revised 16 January 2014       Accepted 27 January 2014

Copyright © 2014 Korean Foot and Ankle Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study is to evaluate the clinical and radiographic results of internal fixation using multiple Kirschner wires (K-wires) for the fifth metatarsal base fracture.

Materials and Methods

We retrospectively reviewed 14 patients with a displaced fifth metatarsal base fracture. We measured the distance of fracture displacement on the foot oblique radiograph pre- and post-operatively. We evaluated the clinical results using the visual analog pain scale at six weeks and three months postoperatively and the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score at six months postoperatively.

Results

In our series, 10 cases were zone I fracture and four cases were zone II fracture. We achieved anatomical reduction and bony union in all of our cases. The average time to bone union was 43 days. The degree of pain around the fifth metatarsal base was significantly decreased after surgery. The average AOFAS score was 95 at six months postoperatively.

Conclusion

Multiple K-wire fixation is a relatively simple fixation method for displaced fifth metatarsal base fractures. If we place a K-wire into the medial cortex of the fifth metatarsal, we could prevent proximal migration of the K-wire.

Keywords: Proximal fifth metatarsal fracture, Kirschner wires

References

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Figure 1.
(A) A 34-year-old woman with displaced intraarticular avulsion fracture of the fifth metatarsal. (B) Immediate postoperative foot anteroposterior image after open reduction and internal fixation with 3 Kirschner wires. (C) Immediate postoperative foot oblique image showing anatomically reduced fifth metatarsal base fracture. (D) Final foot oblique image after implant removal 7 months postoperatively.
jkfas-18-24f1.tif
Figure 2.
The average visual analogue pain scale was significantly decreased after surgery (p<0.001). Preop: preoperative, Postop: postoperative.
jkfas-18-24f2.tif
Table 1.
Patient Demographics and Clinical Data
No. Age (yr) Sex Type Preop displacement (mm) Preop VAS Number of K-wires Postop displacement (mm) Implant removal Postop AOFAS Time to union (day)
1 39 M I 4 8 2 0 Postop 6 mo 94 38
2 53 M I 3 7 3 0 Postop 7 mo 92 40
3 29 M I 8 9 3 1 Postop 8 mo 94 43
4 29 F I 3 6 2 0 Postop 6 mo 95 41
5 38 F I 2 7 3 0   100 40
6 55 M I 3 8 5 1   90 43
7 31 F I 4 7 4 0   92 43
8 34 F I 3 7 3 0 Postop 6 mo 98 42
9 38 M I 4 7 4 0   92 45
10 23 F I 3 8 4 0 Postop 6 mo 98 42
11 42 M II 2 6 3 1   95 45
12 18 M II 3 6 2 0 Postop 6 mo 97 48
13 21 F II 3 5 3 0 Postop 6 mo 94 43
14 46 M II 3 9 3 0   97 43

Preop: preoperative, VAS: visual analogue scale score, K-wires: Kirschner wires, Postop: postoperative, AOFAS: American Orthopaedic Foot and Ankle Society midfoot score, M: male, F: female.

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