The outcome of cannulated cancellous screw fixation for treatment of base of fifth metatarsal fractures

Abstract

Background: The fracture of the base of the fifth metatarsal is one of the common fractures that occur in 5th decade of life in the foot. Stable fixation with the cannulated cancellous screw provided early healing and patients can return to their work early.

Aims and Objectives: The aim of the study is to find the functional outcome of closed reduction and internal fixation with cannulated cancellous screw fixation for the displaced base of fifth metatarsal fractures, to evaluate the clinical and radiological union of fifth metatarsal fractures, and to study the complications of treatment of fifth metatarsal fractures.

Materials and Methods: This prospective study was conducted in the Department of Orthopaedics Manipal teaching hospital Pokhara, Nepal, from February 2022 to January 2023. A total of 35 patients with the fractured fifth metatarsal base were included in the study. The patient was kept in a supine position with a pillow under the knee so that the knee was flexed to 90° and the foot was plantigrade. A cannulated cancellous screw of the appropriate size was inserted along with a washer to fix the fracture.

Results: There were a total of 35 patients with the base of 5th metatarsal fractures. The mean age of the patient was 36.94±8.04 years, with males 22 (62.9%) and females 13 (37.1%). The left side commonly involves 22 (62.9%). The history twisting injury is the most common mode of injury. All patients had a union of fracture by 7.09±1.07 weeks ranging from 6 to 9 weeks. There were no cases of sural nerve injuries in our study.

Conclusion: The base of fifth metatarsal fractures is commonly seen in athletes and patients around 40 years of age. Closed reduction under image guidance and stable fixation with cannulated cancellous screw fixation provides early healing of fractures. Patients can return to work early.