Best Practice Case Studies-Foot

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The provided text focuses on the considerations and treatment options for 5th metatarsal fractures in athletes. It presents two study questions related to the topic.<br /><br />The first question involves a 22-year-old male soccer player diagnosed with a non-displaced fifth metatarsal fracture. It queries which fracture location is most susceptible to nonunion. The options given range from different areas of the bone: diaphysis, metaphyseal-diaphyseal junction, metaphysis, and proximal tubercle. The correct answer is the metaphyseal-diaphyseal junction, which has the highest risk of nonunion due to its poor vascular supply. This area is considered a watershed, with blood from a nutrient artery that originates from the adjacent metatarsal artery. Treatment for nonunion risk fractures, especially in competitive athletes, might involve operative fixation, while other types of fractures, like proximal tubercle and non-displaced metaphyseal fractures, can typically heal well with conservative measures like using a stiff-soled shoe.<br /><br />The second question addresses the treatment for a nondisplaced proximal tuberosity fracture of the 5th metatarsal in a skeletally mature athlete. The correct approach is option B: protecting the fracture with a nonpainful weight-bearing in a hard-soled shoe or cam boot, progressing to weight-bearing as tolerated. These fractures heal well due to adequate blood supply. The scenario describes a pseudo-Jones fracture in zone one of the fifth metatarsal—a type that's often treated with symptomatic management. Options A and C mention treatment suitable for Jones fractures in zone two, which have a more challenging healing process due to compromised blood flow. Option D describes management for shaft fractures, which require long-term protected weight-bearing and possible surgical consultation if they don't heal conservatively.<br /><br />In conclusion, the document outlines the importance of understanding fracture location, blood supply, and appropriate treatment strategies for different types of fifth metatarsal fractures in athletes.

Meta Tag

Edition 3rd Edition

Related Case 3rd Edition, CASE 18

Topic Foot

Keywords

5th metatarsal fracture

athletes

nonunion risk

metaphyseal-diaphyseal junction

operative fixation

conservative treatment

pseudo-Jones fracture

weight-bearing

blood supply

fracture management

3rd Edition

3rd Edition, CASE 18

Foot