Surgical Excision of Symptomatic Nonunion of Fifth Metatarsal Base Avulsion Fracture in Athletes

Kyung Tai Lee; Jun Beom Kim; Ki Won Young; Young Uk Park; Jin Su Kim; Hyuk Jegal

doi:10.5763/kjsm.2011.29.2.118

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Lee, Kim, Young, Park, Kim, and Jegal: Surgical Excision of Symptomatic Nonunion of Fifth Metatarsal Base Avulsion Fracture in Athletes

Clinical Article

Korean J Sports Med 2011;29(2):118-121.

Published online: 20 January 2011

DOI: https://doi.org/10.5763/kjsm.2011.29.2.118

Surgical Excision of Symptomatic Nonunion of Fifth Metatarsal Base Avulsion Fracture in Athletes

Kyung Tai Lee, MD¹, Jun Beom Kim, MD², Ki Won Young, MD³, Young Uk Park, MD¹, Jin Su Kim, MD³, Hyuk Jegal, MD¹

¹KT Lee's Orthopedic Hospital, Foot and Ankle Clinic, Seoul, Korea

²Department of Orthopedic Surgery, Sun General Hospital, Daejeon, Korea

³Department of Orthopedic Surgery, Eulji Medical Center, Seoul, Korea

Received 15 September 2011 Revised 21 November 2011 Accepted 22 November 2011

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

The purpose of this study was to evaluate the clinical results of surgical excision of symptomatic nonunion of fifth metatarsal base avulsion fracture in athletes. From February 2008 to December 2009, six athletic patients who had a symptomatic nonunion of fifth metatarsal base avulsion fracture underwent surgical excision of ununited bony fragment and they were followed for more than 12 months. The mean age was 18.5 years and the mean follow-up period was 13 months. The clinical results were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) forefoot scoring system and Visual Analogue Scale (VAS) scoring system and statistically analyzed (SPSS ver. 18.0). The AOFAS and VAS score was improved in all patients. The mean AOFAS forefoot score was improved from 58.6±5.7 preoperatively to 95±5.4 postoperatively, which indicated significant difference (p=0.024). The mean preoperative VAS score was 8.0±0.6 and the mean postoperative VAS score was 1.6±0.5 cm, which indicated significant difference (p=0.023). There were no postoperative problems and functional loss on the operation lesions. The surgical excision of symptomatic nonunion of fifth metatarsal base avulsion fracture in athletes was found to be one of the ideal treatment option for early return to full activity and relief of pain.

Keywords: Symptomatic nonunions, Avulsion fracture of proximal fifth metatarsal, Surgical excision

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Fig. 1.

The symptomatic nonunion of the proximal fifth metatarsal. (A) Preoperative oblique view. This radiograph shows the nonunion of proximal 5th metatarsal bone. (B) Postoperative oblique view. This radiograph shows that bone fragment is removed.

Fig. 2.

Surgical excision of the bone fragment, which was not united on proximal 5th metatarsal bone. A lateral skin incision is used to expose the bone fragment. And then, bone fragment was shelled out.

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