The treatment of Zone 1 fractures of the 5th metatarsal base with >2 mm of displacement remains controversial. We prospectively analyzed 29 patients with 5th metatarsal base fractures (Zone 1) during 2009–2014. Radiography was performed to assess the degree of fracture gap and metatarsal length. Patients with gaps of 2 mm or less were treated conservatively using a short leg cast or splint (Group A), while patients with fracture gap >2 mm were randomly assigned to one of two groups. Group B patients were managed with open reduction and internal fixation (ORIF), and Group C patients were placed in a short leg cast only. Visual analog scale (VAS) score and American orthopedic foot and ankle society (AOFAS) score were obtained at the initial consult and at the last follow-up after treatment; change of the 5th metatarsal length was also measured at the initial consult and after complete bony union. Our study demonstrated that radiographic union of all cases was observed with a significant decrease in VAS and AOFAS scores, regardless of the initial fracture gap and type of management. Additionally, there was no difference seen in final VAS scores for patients with longer metatarsals when compared to those in whom the metatarsals were unchanged or shortened.
- 5th Metatarsal base fracture (Zone 1)
- American orthopedic foot and ankle society (AOFAS) score
- Metatarsal length
- Visual analogue scale (VAS) score
ASJC Scopus subject areas
- Emergency Medicine
- Orthopedics and Sports Medicine