Comparative study of surgical and conservative treatments for fifth metatarsal base avulsion fractures (type I) in young adults or athletes.

PURPOSE: This study aimed to investigate the therapeutic effects and complications of minimally invasive surgery in treating displaced avulsion fractures (2-3 mm) of fifth metatarsal base zone I in young adults or athletes.

METHODS: Forty-six patients with displaced fifth metatarsal base avulsion fractures were assigned to operative and nonoperative groups by randomization. Patients in nonoperative group were immobilized with plaster, while patients in operative group were treated with closed reduction and fixation with a percutaneous screw.

RESULTS: All patients were followed up for 14 months on average (ranging from 12 to 24 months). All cases got primary union except for three patients in nonoperative group with malunion and two with frequent mild to moderate plantar pain. The American Orthopaedic Foot and Ankle Society score was significantly better in operative group at 6 months after treatment ( p < 0.05) but not significantly different at 12 months after treatment ( p > 0.05). The average time of full weight bearing and returning to work was significantly shorter in operative group than nonoperative group ( p < 0.05).

CONCLUSION: In young adults or athletes with displaced avulsion fractures of fifth metatarsal base zone I, closed reduction and percutaneous screw fixation provides anatomical stable fixation and early mobilization.