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• W2026947770 abstract "This clinical practice guideline (CPG) is based upon consensus of current clinical practice and review of the clinical literature. The guideline was developed by the Clinical Practice Guideline Forefoot Disorders Panel of the American College of Foot and Ankle Surgeons. The guideline and references annotate each node of the corresponding pathways.Trauma (Pathway 6)Trauma in the forefoot can range from simple, nondisplaced fractures to limb-threatening injuries. Proper evaluation and diagnosis is critical to determine the extent of injury and appropriate treatment.Significant History (Pathway 6, Node 1)Trauma to the toes, lesser metatarsals, and their respective joints involves various mechanisms and injury types (1Galant J.M. Spinosa F.A. Digital fractures A comprehensive review.J Am Podiatr Med Assoc. 1991; 81: 593-600Crossref PubMed Scopus (6) Google Scholar, 2Mandracchia V.J. Mandi D.M. Toney P.A. Halligan J.B. Nickles W.A. Fractures of the forefoot.Clin Podiatr Med Surg. 2006; 23 (vi): 283-301Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar). These include a history of both direct and indirect trauma. Patients may exhibit symptoms acutely at the time of trauma or at a later onset. Symptoms include pain, swelling, discoloration, loss of joint motion, and difficulty standing and/or walking. An accurate history of the inciting traumatic event should be elicited.Significant Findings (Pathway 6, Node 2)Clinical examination of the traumatized forefoot may show pain upon palpation and motion of affected joints. The patient may have decreased range of motion, with or without tendon dysfunction. Deformity may or may not be present. The patient may experience pain with or without weightbearing. Soft tissue damage must be evaluated and any neurovascular compromise recognized. Edema is common and often does not allow a shoe to be worn. Ecchymosis and/or erythema may be present, depending on the injury type.Radiographic Findings (Pathway 5, Node 3)Radiographs are indicated in most cases of trauma to the forefoot to rule out fracture and/or joint dislocation. Anterior-posterior, lateral, and oblique views may be obtained with the patient in either a weightbearing or nonweightbearing position. In some cases, stress views under anesthesia may be required to identify the injuries.Positive Diagnosis for Fracture or Dislocation (Pathway 6, Node 4)Fractures should be evaluated and treated appropriately. Special attention should be directed to restoring articular congruity and segmental alignment, paying particular attention to maintaining alignment in the sagittal plane. Nondisplaced fractures of the forefoot may require only appropriate immobilization (Fig. 1), whereas displaced fractures may require closed or open reduction techniques (3Anderson E.G. Fatigue fractures of the foot.Injury. 1990; 21: 275-279Abstract Full Text PDF PubMed Scopus (36) Google Scholar, 4Shereff M.J. Complex fractures of the metatarsals.Orthopedics. 1990; 13: 875-882PubMed Google Scholar, 5Zenios M. Kim W.Y. Sampath J. Muddu B.N. Functional treatment of acute metatarsal fractures: a prospective randomised comparison of management in a cast versus elasticated support bandage.Injury. 2005; 36: 832-835Abstract Full Text Full Text PDF PubMed Scopus (49) Google Scholar) (FIGURE 2, FIGURE 3). Of special note are fractures of the proximal diaphyseal area of the fifth metatarsal (Jones fracture) (6Vogler H.W. Westlin N. Mlodzienski A.J. Moller F.B. Fifth metatarsal fractures Biomechanics, classification, and treatment.Clin Podiatr Med Surg. 1995; 12: 725-747PubMed Google Scholar, 7Herrera-Soto J.A. Scherb M. Duffy M.F. Albright J.C. Fractures of the fifth metatarsal in children and adolescents.J Pediatr Orthop. 2007; 27: 427-431Crossref PubMed Scopus (30) Google Scholar, 8O'Shea M.K. Spak W. Sant'Anna S. Johnson C. Clinical perspective of the treatment of fifth metatarsal fractures.J Am Podiatr Med Assoc. 1995; 85: 473-480Crossref PubMed Scopus (9) Google Scholar) (Fig. 4). Although many fractures of this type may be treated with immobilization and avoidance of weightbearing, internal fixation may be indicated in some patient populations (eg, high-caliber athletes) (9Fetzer G.B. Wright R.W. Metatarsal shaft fractures and fractures of the proximal fifth metatarsal.Clin Sports Med. 2006; 25 (x): 139-150Abstract Full Text Full Text PDF PubMed Scopus (62) Google Scholar, 10Glasgow M.T. Naranja Jr, R.J. Glasgow S.G. Torg J.S. Analysis of failed surgical management of fractures of the base of the fifth metatarsal distal to the tuberosity: the Jones fracture.Foot Ankle Int. 1996; 17: 449-457Crossref PubMed Scopus (132) Google Scholar, 11Hens J. Martens M. Surgical treatment of Jones fractures.Arch Orthop Trauma Surg. 1990; 109: 277-279Crossref PubMed Scopus (29) Google Scholar, 12Josefsson P.O. Karlsson M. Redlund-Johnell I. Wendeberg B. Closed treatment of Jones fracture Good results in 40 cases after 11-26 years.Acta Orthop Scand. 1994; 65: 545-547Crossref PubMed Scopus (51) Google Scholar, 13Josefsson P.O. Karlsson M. Redlund-Johnell I. Wendeberg B. Jones fracture Surgical versus nonsurgical treatment.Clin Orthop Relat Res. 1994; 299: 252-255PubMed Google Scholar, 14Kavanaugh J.H. Brower T.D. Mann R.V. The Jones fracture revisited.J Bone Joint Surg Am. 1978; 60: 776-782PubMed Google Scholar, 15Larson C.M. Almekinders L.C. Taft T.N. Garrett W.E. Intramedullary screw fixation of Jones fractures Analysis of failure.Am J Sports Med. 2002; 30: 55-60PubMed Google Scholar, 16Low K. Noblin J.D. Browne J.E. Barnthouse C.D. Scott A.R. Jones fractures in the elite football player.J Surg Orthop Adv. 2004; 13: 156-160PubMed Google Scholar, 17Mindrebo N. Shelbourne K.D. Van Meter C.D. Rettig A.C. Outpatient percutaneous screw fixation of the acute Jones fracture.Am J Sports Med. 1993; 21: 720-723Crossref PubMed Scopus (87) Google Scholar, 18Mologne T.S. Lundeen J.M. Clapper M.F. O'Brien T.J. Early screw fixation versus casting in the treatment of acute Jones fractures.Am J Sports Med. 2005; 33: 970-975Crossref PubMed Scopus (148) Google Scholar, 19Munro T.G. Fractures of the base of the fifth metatarsal.Can Assoc Radiol J. 1989; 40: 260-261PubMed Google Scholar, 20Nunley J.A. Fractures of the base of the fifth metatarsal: the Jones fracture.Orthop Clin North Am. 2001; 32: 171-180Abstract Full Text Full Text PDF PubMed Scopus (80) Google Scholar, 21Pietropaoli M.P. Wnorowski D.C. Werner F.W. Fortino M.D. Intramedullary screw fixation of Jones fractures: a biomechanical study.Foot Ankle Int. 1999; 20: 560-563Crossref PubMed Scopus (58) Google Scholar, 22Porter D.A. Duncan M. Meyer S.J. Fifth metatarsal Jones fracture fixation with a 4.5-mm cannulated stainless steel screw in the competitive and recreational athlete: a clinical and radiographic evaluation.Am J Sports Med. 2005; 33: 726-733Crossref PubMed Scopus (127) Google Scholar, 23Richli W.R. Rosenthal D.I. Avulsion fracture of the fifth metatarsal: experimental study of pathomechanics.Am J Roentgenol. 1984; 143: 889-891Crossref PubMed Scopus (78) Google Scholar, 24Sammarco G.J. The Jones fracture.Instr Course Lect. 1993; 42: 201-205PubMed Google Scholar, 25Fetzer G.B. Wright R.W. Metatarsal shaft fractures and fractures of the proximal fifth metatarsal.Clin Sports Med. 2006; 25 (x): 139-150Abstract Full Text Full Text PDF PubMed Scopus (23) Google Scholar, 26Konkel K.F. Menger A.G. Retzlaff S.A. Nonoperative treatment of fifth metatarsal fractures in an orthopaedic suburban private multispeciality practice.Foot Ankle Int. 2005; 26: 704-707PubMed Google Scholar). Significant intra-articular injury of the interphalangeal or metatarsophalangeal joint may require subsequent arthroplasty.FIGURE 1Fifth metatarsal fractures are not uncommon. This spiral oblique fracture visualized on (A) anteroposterior and (B) oblique radiographs was treated nonsurgically with immobilization. (C, D, and E) Gradual progression to bony union and good alignment is shown in these radiographs.View Large Image Figure ViewerDownload Hi-res image Download (PPT)FIGURE 2The fifth metatarsal base avulsion fracture is visualized on this (A) radiograph and (B) intraoperative photograph. The patient underwent open reduction–internal fixation with tension-banding of the fracture, as shown in the (D) intraoperative view and on postsurgical (E) anteroposterior and (F) lateral radiographs.View Large Image Figure ViewerDownload Hi-res image Download (PPT)FIGURE 3This patient suffered an injury with fracture of the third and fourth metatarsals. (A) anteroposterior and (B) oblique radiographs show lateral displacement. The patient underwent open reduction–internal fixation with kirschner wire stabilization illustrated by (C) anteroposterior and (D) lateral postoperative radiographs.View Large Image Figure ViewerDownload Hi-res image Download (PPT)FIGURE 4The proximal fifth metatarsal fracture or Jones fracture has a poor prognosis compared with the avulsion fracture. This patient underwent open reduction–internal fixation with a axial screw through the tuberosity. (A) Intraoperative radiography and (B) clinical presentation illustrate screw orientation down medullary canal. (C) anteroposterior and (D) oblique radiographs show final screw placement.View Large Image Figure ViewerDownload Hi-res image Download (PPT)Dislocations of the interphalangeal joints of the lesser toes probably are somewhat more common than dislocations of the metatarsophalangeal joint. Traumatic dislocations most often occur in the dorsal direction or in the transverse plane. Acute treatment focuses on reduction of the joint dislocation, which usually can be accomplished in a closed fashion (Fig. 5). In some cases, soft tissue interposition may require open reduction. Late repair and balancing of capsuloligamentous tissues rarely is necessary.FIGURE 5(A) MPJ dislocations occur, and this radiograph shows the displacement. (B) Closed reduction was performed in a Chinese finger-trap, with gravity reduction providing an (C) anatomic alignment.View Large Image Figure ViewerDownload Hi-res image Download (PPT)Diagnosis and treatment of any concomitant soft tissue injury (eg, soft tissue wound, tendon injury, compartment syndrome) are carried out appropriately. If clinical improvement is not seen within the expected timeframe, further diagnostic imaging such as technetium bone scan, magnetic resonance imaging (MRI), computed tomography (CT), or ultrasound may be indicated to evaluate for non-union or unrecognized osseous or soft tissue injury.Negative Diagnosis for Fracture or Dislocation (Pathway 6, Node 5)Trauma to the forefoot is always associated with a degree of soft tissue injury (27Myerson M.S. McGarvey W.C. Henderson M.R. Hakim J. Morbidity after crush injuries to the foot.J Orthop Trauma. 1994; 8: 343-349Crossref PubMed Scopus (57) Google Scholar). This may include a variety of soft tissue conditions.Puncture wounds of the foot are not uncommon and may or may not be associated with a retained foreign body (28Armstrong D.G. Lavery L.A. Quebedeaux T.L. Walker S.C. Surgical morbidity and the risk of amputation due to infected puncture wounds in diabetic versus nondiabetic adults.J Am Podiatr Med Assoc. 1997; 87: 321-326Crossref PubMed Scopus (30) Google Scholar, 29Chang H.C. Verhoeven W. Chay W.M. Rubber foreign bodies in puncture wounds of the foot in patients wearing rubber-soled shoes.Foot Ankle Int. 2001; 22: 409-414PubMed Google Scholar). Appropriate wound care must be performed acutely, along with assurance of updated tetanus prophylaxis (30Das De S. McAllister T.A. Pseudomonas osteomyelitis following puncture wounds of the foot in children.Injury. 1981; 12: 334-339Abstract Full Text PDF PubMed Scopus (10) Google Scholar, 31del Rosario N.C. Rickman L.S. Klebsiella pneumoniae infection complicating a puncture wound of the foot: a case report.Mil Med. 1989; 154: 38-39PubMed Google Scholar, 32Dixon R.S. Sydnor IV, C.H. Puncture wound pseudomonal osteomyelitis of the foot.J Foot Ankle Surg. 1993; 32: 434-442PubMed Google Scholar, 33Edlich R.F. Rodeheaver G.T. Horowitz J.H. Morgan R.F. Emergency department management of puncture wounds and needlestick exposure.Emerg Med Clin North Am. 1986; 4: 581-593PubMed Google Scholar, 34Fitzgerald Jr, R.H. Cowan J.D. Puncture wounds of the foot.Orthop Clin North Am. 1975; 6: 965-972PubMed Google Scholar, 35Graham B.S. Gregory D.W. Pseudomonas aeruginosa causing osteomyelitis after puncture wounds of the foot.South Med J. 1984; 77: 1228-1230Crossref PubMed Scopus (10) Google Scholar, 36Green N.E. Bruno III, J. Pseudomonas infections of the foot after puncture wounds.South Med J. 1980; 73: 146-149Crossref PubMed Scopus (19) Google Scholar, 37Hamilton W.C. Injuries of the ankle and foot.Emerg Med Clin North Am. 1984; 2: 361-389PubMed Google Scholar, 38Inaba A.S. Zukin D.D. Perro M. An update on the evaluation and management of plantar puncture wounds and Pseudomonas osteomyelitis.Pediatr Emerg Care. 1992; : 838-844Google Scholar, 39Jacobs R.F. McCarthy R.E. Elser J.M. Pseudomonas osteochondritis complicating puncture wounds of the foot in children: a 10-year evaluation.J Infect Dis. 1989; 160: 657-661Crossref PubMed Scopus (70) Google Scholar, 40Johnson J.H. Puncture wounds of the foot.Vet Med Small Anim Clin. 1970; 65: 147-152PubMed Google Scholar, 41Joseph W.S. LeFrock J.L. Infections complicating puncture wounds of the foot.J Foot Surg. 1987; 26: S30-S33PubMed Google Scholar, 42Lavery L.A. Harkless L.B. Felder-Johnson K. Mundine S. Bacterial pathogens in infected puncture wounds in adults with diabetes.J Foot Ankle Surg. 1994; 33: 91-97PubMed Google Scholar). When seen subacutely, puncture wounds may present with signs and symptoms of infection, necessitating more aggressive incision and drainage as well as indicated laboratory testing. Further diagnostic imaging such as MRI and ultrasound may be indicated to identify a suspected retained foreign body not revealed on radiographic studies (43Barber M.J. Sampson S.N. Schneider R.K. Baszler T. Tucker R.L. Use of magnetic resonance imaging to diagnose distal sesamoid bone injury in a horse.J Am Vet Med Assoc. 2006; 229: 717-720Crossref PubMed Scopus (11) Google Scholar, 44Brunner U.H. Blahs U. Kenn R.W. The traumatized foot—clinical and radiological study.Orthopade. 1991; 20: 11-21PubMed Google Scholar, 45Chao K.H. Lee C.H. Lin L.C. Surgery for symptomatic Freiberg's disease: extraarticular dorsal closing-wedge osteotomy in 13 patients followed for 2-4 years.Acta Orthop Scand. 1999; 70: 483-486Crossref PubMed Scopus (62) Google Scholar, 46Chuckpaiwong B. Cook C. Nunley J.A. Stress fractures of the second metatarsal base occur in nondancers.Clin Orthop Relat Res. 2007; 461: 197-202PubMed Google Scholar, 47Cusmano F. Bellelli A. Pedrazzini M. Uccelli M. Ferrozzi F. Devoti D. et al.Spiral CT and MR in injuries of the ankle and the foot.Acta Biomed Ateneo Parmense. 2000; 71: 281-289PubMed Google Scholar).Nail and nail bed injuries range from simple subungual hematoma to open fracture with tissue loss. Approximately one fourth of injuries with subungual hematomas also have fractures of the distal phalanx (48Chudnofsky C.R. Sebastian S. Special wounds Nail bed, plantar puncture, and cartilage.Emerg Med Clin North Am. 1992; 10: 801-822PubMed Google Scholar, 49Farrington G.H. Subungual heamatome: an evaluation of treatment.Br J Med. 1964; 21: 742-744Crossref Scopus (6) Google Scholar, 50Tucker D.J. Jules K.T. Raymond F. Nailbed injuries with hallucal phalangeal fractures—evaluation and treatment.J Am Podiatr Med Assoc. 1996; 86: 170-173Crossref PubMed Scopus (5) Google Scholar). Nailbed lacerations frequently are associated with subungual hematomas. Simple nail bed lacerations can be irrigated and sutured with absorbable sutures (51Wallace G.F. Pachuda N.M. Gumann G. Open fractures.in: Gumann G. Fractures of the Foot and Ankle. Elsevier, Philadelphia2004: 1-41Google Scholar). A nail bed laceration associated with a fracture of the distal phalanx is technically an open fracture and should be treated accordingly. Degloving injuries involving the nail and distal phalanx can be treated with resection of bone to a proximal level, which allows for adequate soft tissue coverage (52Adelaar R.S. Complications of forefoot and midfoot fractures.Clin Orthop Relat Res. 2001; 391: 26-32Crossref PubMed Scopus (30) Google Scholar).Tendon disruption occurs most commonly with laceration and rarely with closed injury (Fig. 6). The majority of cases of extensor hallucis longus (especially proximal to the hood apparatus) and flexor hallucis longus disruption are treated with open repair of the tendon (53Morvan G. Vuillemin-Bodaghi V. Mathieu P. Wybier M. Busson J. Normal and abnormal imaging of the foot's extensor system.J Radiol. 2007; 88: 143-155Crossref PubMed Google Scholar). The literature is less clear regarding the treatment of extensor digitorum longus and flexor digitorum longus disruption.FIGURE 6(A) Intraoperative view of patient who suffered laceration of dorsum of foot with severing of her extensor tendons. Intraoperative views show (B) transected tendons, (C) subsequent repair, and (D) final wound closure.View Large Image Figure ViewerDownload Hi-res image Download (PPT)The attention and care given to the soft tissue envelope is an integral part of the evaluation and management of any forefoot injury. High-energy and crush injuries should raise the level of suspicion for compartment syndrome (54Corey S.V. Cicchinelli L.D. Pitts T.E. Vascular decompression The critical element in forefoot crush injury.J Am Podiatr Med Assoc. 1994; 84: 289-296Crossref PubMed Scopus (2) Google Scholar, 55Jeffers R.F. Tan H.B. Nicolopoulos C. Kamath R. Giannoudis P.V. Prevalence and patterns of foot injuries following motorcycle trauma.J Orthop Trauma. 2004; 18: 87-91Crossref PubMed Scopus (47) Google Scholar). Clinical signs include digital weakness or paralysis, gross edema, tense compartments, parasthesias, mottled skin, and unrelieved pain (51Wallace G.F. Pachuda N.M. Gumann G. Open fractures.in: Gumann G. Fractures of the Foot and Ankle. Elsevier, Philadelphia2004: 1-41Google Scholar, 56Manoli II, A. Compartment syndromes of the foot: current concepts.Foot Ankle. 1990; 10: 340-344Crossref PubMed Scopus (69) Google Scholar). Compartment pressures of the foot above 30 mm Hg to 35 mm Hg are diagnostic for compartment syndrome (57Myerson M. Diagnosis and treatment of compartment syndrome of the foot.Orthopedics. 1990; 13: 711-717PubMed Google Scholar). Surgical decompression is indicated if compartment syndrome is suspected from clinical findings and/or compartment pressures (58Goldman F.D. Dayton P.D. Hanson C.J. Compartment syndrome of the foot.J Foot Surg. 1990; 29: 37-43PubMed Google Scholar, 59Manoli II, A. Weber T.G. Fasciotomy of the foot: an anatomical study with special reference to release of the calcaneal compartment.Foot Ankle. 1990; 10: 267-275Crossref PubMed Scopus (121) Google Scholar, 60Myerson M. Acute compartment syndromes of the foot.Bull Hosp Jt Dis Orthop Inst. 1987; 47: 251-261PubMed Google Scholar).Lacerations, abrasions, and degloving injuries also may involve the forefoot (61DeCoster T.A. Miller R.A. Management of traumatic foot wounds.J Am Acad Orthop Surg. 1994; 2: 226-230PubMed Google Scholar). Evaluation for associated neurovascular compromise, tendon injury, and other injuries must be performed. This clinical practice guideline (CPG) is based upon consensus of current clinical practice and review of the clinical literature. The guideline was developed by the Clinical Practice Guideline Forefoot Disorders Panel of the American College of Foot and Ankle Surgeons. The guideline and references annotate each node of the corresponding pathways. Trauma (Pathway 6)Trauma in the forefoot can range from simple, nondisplaced fractures to limb-threatening injuries. Proper evaluation and diagnosis is critical to determine the extent of injury and appropriate treatment.Significant History (Pathway 6, Node 1)Trauma to the toes, lesser metatarsals, and their respective joints involves various mechanisms and injury types (1Galant J.M. Spinosa F.A. Digital fractures A comprehensive review.J Am Podiatr Med Assoc. 1991; 81: 593-600Crossref PubMed Scopus (6) Google Scholar, 2Mandracchia V.J. Mandi D.M. Toney P.A. Halligan J.B. Nickles W.A. Fractures of the forefoot.Clin Podiatr Med Surg. 2006; 23 (vi): 283-301Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar). These include a history of both direct and indirect trauma. Patients may exhibit symptoms acutely at the time of trauma or at a later onset. Symptoms include pain, swelling, discoloration, loss of joint motion, and difficulty standing and/or walking. An accurate history of the inciting traumatic event should be elicited.Significant Findings (Pathway 6, Node 2)Clinical examination of the traumatized forefoot may show pain upon palpation and motion of affected joints. The patient may have decreased range of motion, with or without tendon dysfunction. Deformity may or may not be present. The patient may experience pain with or without weightbearing. Soft tissue damage must be evaluated and any neurovascular compromise recognized. Edema is common and often does not allow a shoe to be worn. Ecchymosis and/or erythema may be present, depending on the injury type.Radiographic Findings (Pathway 5, Node 3)Radiographs are indicated in most cases of trauma to the forefoot to rule out fracture and/or joint dislocation. Anterior-posterior, lateral, and oblique views may be obtained with the patient in either a weightbearing or nonweightbearing position. In some cases, stress views under anesthesia may be required to identify the injuries.Positive Diagnosis for Fracture or Dislocation (Pathway 6, Node 4)Fractures should be evaluated and treated appropriately. Special attention should be directed to restoring articular congruity and segmental alignment, paying particular attention to maintaining alignment in the sagittal plane. Nondisplaced fractures of the forefoot may require only appropriate immobilization (Fig. 1), whereas displaced fractures may require closed or open reduction techniques (3Anderson E.G. Fatigue fractures of the foot.Injury. 1990; 21: 275-279Abstract Full Text PDF PubMed Scopus (36) Google Scholar, 4Shereff M.J. Complex fractures of the metatarsals.Orthopedics. 1990; 13: 875-882PubMed Google Scholar, 5Zenios M. Kim W.Y. Sampath J. Muddu B.N. Functional treatment of acute metatarsal fractures: a prospective randomised comparison of management in a cast versus elasticated support bandage.Injury. 2005; 36: 832-835Abstract Full Text Full Text PDF PubMed Scopus (49) Google Scholar) (FIGURE 2, FIGURE 3). Of special note are fractures of the proximal diaphyseal area of the fifth metatarsal (Jones fracture) (6Vogler H.W. Westlin N. Mlodzienski A.J. Moller F.B. Fifth metatarsal fractures Biomechanics, classification, and treatment.Clin Podiatr Med Surg. 1995; 12: 725-747PubMed Google Scholar, 7Herrera-Soto J.A. Scherb M. Duffy M.F. Albright J.C. Fractures of the fifth metatarsal in children and adolescents.J Pediatr Orthop. 2007; 27: 427-431Crossref PubMed Scopus (30) Google Scholar, 8O'Shea M.K. Spak W. Sant'Anna S. Johnson C. Clinical perspective of the treatment of fifth metatarsal fractures.J Am Podiatr Med Assoc. 1995; 85: 473-480Crossref PubMed Scopus (9) Google Scholar) (Fig. 4). Although many fractures of this type may be treated with immobilization and avoidance of weightbearing, internal fixation may be indicated in some patient populations (eg, high-caliber athletes) (9Fetzer G.B. Wright R.W. Metatarsal shaft fractures and fractures of the proximal fifth metatarsal.Clin Sports Med. 2006; 25 (x): 139-150Abstract Full Text Full Text PDF PubMed Scopus (62) Google Scholar, 10Glasgow M.T. Naranja Jr, R.J. Glasgow S.G. Torg J.S. Analysis of failed surgical management of fractures of the base of the fifth metatarsal distal to the tuberosity: the Jones fracture.Foot Ankle Int. 1996; 17: 449-457Crossref PubMed Scopus (132) Google Scholar, 11Hens J. Martens M. Surgical treatment of Jones fractures.Arch Orthop Trauma Surg. 1990; 109: 277-279Crossref PubMed Scopus (29) Google Scholar, 12Josefsson P.O. Karlsson M. Redlund-Johnell I. Wendeberg B. Closed treatment of Jones fracture Good results in 40 cases after 11-26 years.Acta Orthop Scand. 1994; 65: 545-547Crossref PubMed Scopus (51) Google Scholar, 13Josefsson P.O. Karlsson M. Redlund-Johnell I. Wendeberg B. Jones fracture Surgical versus nonsurgical treatment.Clin Orthop Relat Res. 1994; 299: 252-255PubMed Google Scholar, 14Kavanaugh J.H. Brower T.D. Mann R.V. The Jones fracture revisited.J Bone Joint Surg Am. 1978; 60: 776-782PubMed Google Scholar, 15Larson C.M. Almekinders L.C. Taft T.N. Garrett W.E. Intramedullary screw fixation of Jones fractures Analysis of failure.Am J Sports Med. 2002; 30: 55-60PubMed Google Scholar, 16Low K. Noblin J.D. Browne J.E. Barnthouse C.D. Scott A.R. Jones fractures in the elite football player.J Surg Orthop Adv. 2004; 13: 156-160PubMed Google Scholar, 17Mindrebo N. Shelbourne K.D. Van Meter C.D. Rettig A.C. Outpatient percutaneous screw fixation of the acute Jones fracture.Am J Sports Med. 1993; 21: 720-723Crossref PubMed Scopus (87) Google Scholar, 18Mologne T.S. Lundeen J.M. Clapper M.F. O'Brien T.J. Early screw fixation versus casting in the treatment of acute Jones fractures.Am J Sports Med. 2005; 33: 970-975Crossref PubMed Scopus (148) Google Scholar, 19Munro T.G. Fractures of the base of the fifth metatarsal.Can Assoc Radiol J. 1989; 40: 260-261PubMed Google Scholar, 20Nunley J.A. Fractures of the base of the fifth metatarsal: the Jones fracture.Orthop Clin North Am. 2001; 32: 171-180Abstract Full Text Full Text PDF PubMed Scopus (80) Google Scholar, 21Pietropaoli M.P. Wnorowski D.C. Werner F.W. Fortino M.D. Intramedullary screw fixation of Jones fractures: a biomechanical study.Foot Ankle Int. 1999; 20: 560-563Crossref PubMed Scopus (58) Google Scholar, 22Porter D.A. Duncan M. Meyer S.J. Fifth metatarsal Jones fracture fixation with a 4.5-mm cannulated stainless steel screw in the competitive and recreational athlete: a clinical and radiographic evaluation.Am J Sports Med. 2005; 33: 726-733Crossref PubMed Scopus (127) Google Scholar, 23Richli W.R. Rosenthal D.I. Avulsion fracture of the fifth metatarsal: experimental study of pathomechanics.Am J Roentgenol. 1984; 143: 889-891Crossref PubMed Scopus (78) Google Scholar, 24Sammarco G.J. The Jones fracture.Instr Course Lect. 1993; 42: 201-205PubMed Google Scholar, 25Fetzer G.B. Wright R.W. Metatarsal shaft fractures and fractures of the proximal fifth metatarsal.Clin Sports Med. 2006; 25 (x): 139-150Abstract Full Text Full Text PDF PubMed Scopus (23) Google Scholar, 26Konkel K.F. Menger A.G. Retzlaff S.A. Nonoperative treatment of fifth metatarsal fractures in an orthopaedic suburban private multispeciality practice.Foot Ankle Int. 2005; 26: 704-707PubMed Google Scholar). Significant intra-articular injury of the interphalangeal or metatarsophalangeal joint may require subsequent arthroplasty.FIGURE 2The fifth metatarsal base avulsion fracture is visualized on this (A) radiograph and (B) intraoperative photograph. The patient underwent open reduction–internal fixation with tension-banding of the fracture, as shown in the (D) intraoperative view and on postsurgical (E) anteroposterior and (F) lateral radiographs.View Large Image Figure ViewerDownload Hi-res image Download (PPT)FIGURE 3This patient suffered an injury with fracture of the third and fourth metatarsals. (A) anteroposterior and (B) oblique radiographs show lateral displacement. The patient underwent open reduction–internal fixation with kirschner wire stabilization illustrated by (C) anteroposterior and (D) lateral postoperative radiographs.View Large Image Figure ViewerDownload Hi-res image Download (PPT)FIGURE 4The proximal fifth metatarsal fracture or Jones fracture has a poor prognosis compared with the avulsion fracture. This patient underwent open reduction–internal fixation with a axial screw through the tuberosity. (A) Intraoperative radiography and (B) clinical presentation illustrate screw orientation down medullary canal. (C) anteroposterior and (D) oblique radiographs show final screw placement.View Large Image Figure ViewerDownload Hi-res image" @default.
• W2026947770 created "2016-06-24" @default.
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• W2026947770 title "Diagnosis and Treatment of Forefoot Disorders. Section 5. Trauma" @default.
• W2026947770 cites W1893349964 @default.
• W2026947770 cites W1966084953 @default.
• W2026947770 cites W1972966300 @default.
• W2026947770 cites W1973392995 @default.
• W2026947770 cites W1974376546 @default.
• W2026947770 cites W1987111292 @default.
• W2026947770 cites W2003087032 @default.
• W2026947770 cites W2010248369 @default.
• W2026947770 cites W2021500336 @default.
• W2026947770 cites W2022439219 @default.
• W2026947770 cites W2028197292 @default.
• W2026947770 cites W2050790118 @default.
• W2026947770 cites W2054251519 @default.
• W2026947770 cites W2063598389 @default.
• W2026947770 cites W2066236985 @default.
• W2026947770 cites W2072734957 @default.
• W2026947770 cites W2076685552 @default.
• W2026947770 cites W2079484170 @default.
• W2026947770 cites W2079564064 @default.
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• W2026947770 cites W2224669949 @default.
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• W2026947770 cites W2325238244 @default.
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• W2026947770 cites W4319688133 @default.
• W2026947770 cites W6584343 @default.
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