CME OnDemand: 2022 AOFAS Annual Meeting-Functional and Radiologic Outcomes Following Fifth Metatarsal Fracture Non-Operative Treatment: A Retrospective Chart Review with Application of the RUST Score From 2019-2021

Functional and Radiologic Outcomes Following Fifth Metatarsal Fracture Non-Operative Treatment: A Retrospective Chart Review with Application of the RUST Score From 2019-2021

Back to course

Pdf Summary

This study aimed to assess the functional and radiologic outcomes of non-operative treatment for base of fifth metatarsal fractures (Zone I-III). The lack of consensus on the management of these fractures and the varied outcomes between operative and non-operative treatments prompted the need for this research. The study involved a retrospective chart review of patients treated between 2019 and 2021.<br /><br />A total of 90 non-operative patients met the inclusion criteria, with an average final follow-up of 93 days. The average time to healing on x-ray was 117 days, while the average time to weight-bearing was 38 days. The time to x-ray evidence of resorption was 42 days, and the time to normal shoe wearing was 66 days. At the fourth visit, 96% of patients were weight bearing and wearing normal shoes, but only 50% had evidence of healing on x-ray.<br /><br />The findings suggest that patients treated non-operatively for base of fifth metatarsal fractures experience significantly shorter functional healing compared to evidence of radiographic healing. Most patients showed signs of resorption on x-ray by the second visit, but many did not continue follow-up for complete radiographic evidence of healing.<br /><br />In summary, this study highlights the differences in functional and radiologic outcomes in non-operative treatment for base of fifth metatarsal fractures. The findings suggest that while patients may achieve functional healing relatively quickly, complete radiographic healing may take longer. Further research is needed to establish a scoring system for radiographic healing and to compare the outcomes of operative and non-operative treatments.

Asset Subtitle

Kylie Van Hoesen, Michael A. Hewitt, BA, Sara E. Buckley, DO, Sara Skluzacek, MPAS, PA-C, Jeremy J. Kalma, MD, Courtney Grimsrud, MD

Keywords

functional outcomes

radiologic outcomes

non-operative treatment

base of fifth metatarsal fractures

Zone I-III

management of fractures

operative treatment

retrospective chart review

time to healing

time to weight-bearing