Displaced fractures are much more likely to require surgery to repair. Non-displaced fractures are still broken bones, but the pieces weren’t moved far enough to be out of alignment during the break. Surgical treatment of acute Jones fractures has been advocated for active and athletic adolescents to avoid issues associated with delayed healing. A displaced fracture means the pieces of your bone moved so much that a gap formed around the fracture when your bone broke. It is important to recognize a zone II injury, the Jones fracture, which is prone to nonunion because of the watershed area of blood supply in this region. Preoperative radiographs and CT scans showed Salter-Harris type III, an isolated Tillaux fragment, with more than 2 mm anterior and lateral displacement. These fractures may be repaired by application of a bone plate, but reduction of the frac- ture may not be possible when the fragment is severely displaced. Zone III begins distal to the ligamentous attachments and extends to the mid-diaphyseal area. Central metatarsal fractures (CMF) are common injuries. teral fragment of the navicular was displaced with shortening. Zone II is the distal aspect of the tuberosity with dorsal and plantar ligamentous attachments to the fourth metatarsal. >2 mm, shortening of the medial column >3 mm, subluxation or dislocation, open fracture. Zone I comprises the cancellous tuberosity, including the insertion of the peroneus brevis tendon and the calcaneometatarsal ligament of the plantar fascia. Open reduction with internal fixation is indicated for patients with open fractures, irreducible fractures, and those that cannot maintain reduction by casting.įractures of the base of the fifth metatarsal are best classified according to their anatomical location which are divided into three zones of the proximal metatarsal. Metatarsal neck fractures are more often caused by a torsional force applied to the foot, whereas direct compression results in shaft fractures. Metatarsal fractures generally result from direct trauma such as a heavy object falling on the foot or a crush injury in a motor vehicle accident or from indirect trauma such as a twisting injury. We compared the biomechanical strength of 2 headless compression screws vs a hook plate for fixation of these fractures. In general, physicians may be accepting of subtle displacement of central metatarsal fractures accepting up to 10 degrees of displacement and 3mm of. ![]() ![]() Their incidence is 1 per 60,000 annually (3). Fortunately, the vast majority of these fractures can be treated conservatively with immobilization alone. Volume 42, Issue 1 Contents PDF / ePub More Abstract Background: Debate exists on the optimum fixation construct for large avulsion fractures of the fifth metatarsal base. The displaced second metatarsal fracture was treated by open reduction and internal fixation using a. Metatarsal bone fractures account for more than half of all pediatric foot fractures and 15% of all injuries of the foot.
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