Orthopaedic Journal of Sports Medicine· 2021Q1· Review
Surgical Management of Proximal Fifth Metatarsal Fractures in Elite Athletes: A Systematic Review
- 16citations
- Q1SCImago
- 2021year
Short summary
Surgical management of proximal fifth metatarsal fractures in elite athletes yields high union rates (96.7%) and a mean return to play of 11.15 weeks, regardless of surgical construct, but carries an overall complication rate exceeding 20%.
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Key points
- Surgical treatment for proximal fifth metatarsal fractures in elite athletes achieved 96.7% radiographic union.
- Elite athletes returned to play at a mean of 11.15 weeks post-surgery.
- Intramedullary screw fixation was the most common surgical approach (47.9%).
- The overall complication rate was 22.5%, with refracture occurring in 8.6% of cases.
AI-generated from the title and abstract; the full text is not read.
Abstract
BACKGROUND: As a result of the high physical demand in sport, elite athletes are particularly prone to fifth metatarsal fractures. These injuries are typically managed surgically to avoid high rates of delayed union and allow for quicker return to play (RTP). PURPOSE: To review studies showing clinical and radiographic outcomes, RTP rates, and complication rates after different surgical treatment modalities for fifth metatarsal fractures exclusively in elite-level athletes. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: A systematic search was conducted within the PubMed, Scopus, and Cochrane databases from January 2000 to January 2020. Inclusion criteria consisted of clinical outcome studies after operative management of fifth metatarsal fractures in elite athletes. Exclusion criteria consisted of nonoperative management, high school or recreational-level athletic participation, nonclinical studies, expert opinions, and case series with <5 patients. RESULTS: A total of 12 studies met inclusion and exclusion criteria, comprising 280 fifth metatarsal fractures treated surgically. Intramedullary screw fixation was the most common fixation construct (47.9%), and some form of intraoperative adjunctive treatment (calcaneal autograft, iliac crest bone graft, bone marrow aspirate concentrate, demineralized bone matrix) was used in 67% of cases. Radiographic union was achieved in 96.7% of fractures regardless of surgical construct used. The overall mean time to union was 9.19 weeks, with RTP at a mean of 11.15 weeks. The overall reported complication rate was 22.5%, with varying severity of complications. Refracture rates were comparable between the different surgical constructs used, and the overall refracture rate was 8.6%. CONCLUSION: Elite athletes appeared to have a high rate of union and reliably returned to the same level of competition after surgical management of fifth metatarsal fractures, irrespective of surgical construct used. Despite this, the overall complication rate was >20%. Specific recommendations for optimal surgical management could not be made based on the heterogeneity of the included studies.
The authors' abstract, as published at the source. Orthopaedic Journal of Sports Medicine, 2021 · DOI ↗
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Field: Biomedical Engineering
Biomedical EngineeringEngineering