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Refracture of Proximal Fifth Metatarsal (Jones) Fracture After Intramedullary Screw Fixation in Athletes
Ist Teil von
The American journal of sports medicine, 2000-09, Vol.28 (5), p.732-736
Ort / Verlag
Los Angeles, CA: American Orthopaedic Society for Sports Medicine
Erscheinungsjahr
2000
Link zum Volltext
Quelle
Alma/SFX Local Collection
Beschreibungen/Notizen
This study details six instances of refracture of clinically and radiographically healed fractures of the base of the fifth
metatarsal after intramedullary screw fixation. Four professional football players, one college basketball player, and one
recreational athlete underwent intramedullary screw fixation of fifth metatarsal fractures. The athletes were released to
full activities an average of 8.5 weeks (range, 5.5 to 12) after fixation, when healing was clinically and radiographically
documented. Three football players developed refracture within 1 day of return to full activity. The other three athletes
refractured at 2.5, 4, and 4.5 months after return to activity. Two football players underwent repeat fixation with larger
screws and returned to play in the same season. The college basketball player underwent bone grafting and returned to play
in subsequent seasons. The other three athletes underwent nonoperative management and healed uneventfully over 6 to 8 weeks.
On the basis of this series, we recommend that 1) screw fixation using a large-diameter screw should be given careful consideration
for patients with large body mass for whom early return to activity is important; 2) functional bracing, shoe modification,
or an orthosis should be considered for return to play; 3) if refracture occurs, exchange to a larger screw may allow return
to play in the same season; and 4) alternative imaging should be considered to help document complete healing.