Operative Techniques in Sports Medicine
Volume 17, Issue 2 , Pages 119-124 , April 2009

Surgical Management of Proximal Fourth Metatarsal Stress Fracture Nonunion: Debridement and Locking Plate Stabilization

  • Michael R. Carmont, FRCS (Tr & Orth)

      Affiliations

    • The Princess Royal Hospital, Telford, United Kingdom
    • Corresponding Author InformationAddress reprint requests to Michael R. Carmont, FRCS (Tr & Orth), Orthopaedic Department, The Princess Royal Hospital, Apley Castle, Telford, TF1 6TF, United Kingdom
    • ,
  • Christopher M. Blundell, FRCS (Tr & Orth)

      Affiliations

    • The Sheffield Foot and Ankle Unit, The Northern General Hospital, Sheffield, United Kingdom
    • ,
  • Brian Straus, MD

      Affiliations

    • Texas Sports Medicine, Dallas, TX
    • ,
  • Douglas R. Turgeon, MD

      Affiliations

    • Texas Sports Medicine, Dallas, TX

References 

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  2. Rammelt S, Heineck J, Zwipp H. Metatarsal fractures. Injury. 2004;35:S-B77–S-B86
  3. Torg JS, Balduini FC, Zelko RR, et al. Fractures of the base of the fifth metatarsal distal to the tuberosity. J Bone Joint Surg Am. 1984;66:209–214
  4. Zelko RR, Torg JS, Rachun A. Proximal diaphyseal fractures of the fifth metatarsal-treatment options and complications in athletes. Am J Sports Med. 1979;7:95–101
  5. Jones R. Fracture of the base of the fifth metatarsal by indirect violence. Ann Surg. 1902;35:697–700
  6. Mologne TS, Lundeen JM, Clapper MF, et al. Early screw fixation versus casting in the treatment of acute Jones fractures. Am J Sports Med. 2005;33:970–975
  7. Popovic N, Jalali A, Georis P, et al. Proximal fifth metatarsal diaphyseal stress fracture in football players. Foot Ankle Surg. 2005;11:135–141
  8. Sarimo J, Orava S, Alanen J. Operative treatment of stress fractures of the proximal second metatarsal. Scand J Med Sci Sports. 2007;17:383–384
  9. Lawrence SJ. Technique tip: Local bone grafting technique for Jones fracture management with intramedullary screw fixation. Foot Ankle Int. 2004;25:920–921
  10. Hetsroni I, Mann G, Dolev E, et al. Base of fourth metatarsal stress fracture: Tendency for prolonged healing. Clin J Sport Med. 2005;15:186–188
  11. Saxena A, Krisdakumtom T, Erickson S. Proximal fourth metatarsal injuries in athletes: Similarity to proximal fifth metatarsal injury. Foot Ankle Int. 2001;22:603–608
  12. Shearer CT, Penner MJ. Stress fractures of the base of the fourth metatarsal. Am J Sports Med. 2007;35:479–483
  13. Dameron TB. Fractures of the proximal fifth metatarsal: Selecting the best treatment option. J Am Acad Orthop Surg. 1995;3:110–114
  14. Fetzer GB, Wright RW. Metatarsal shaft fractures and fractures of the proximal fifth metatarsal. Clin Sports Med. 2006;25:139–150
  15. Rosenberg GA, Sferra JJ. Treatment strategies for acute fractures and nonunions of the proximal fifth metatarsal. J Am Acad Orthop Surg. 2000;8:322–328
  16. Muscolo L, Migues A, Slullitel G, et al. Stress fracture non union at the base of the second metatarsal in a ballet dancer: A case report. Am J Sports Med. 2004;32:1535–1537
  17. Sarimo J, Rantanen J, Orava S, et al. Tension band wiring for fractures of the fifth metatarsal located in the junction of the proximal metaphysic and diaphysis. Am J Sports Med. 2006;34:476–480
  18. Holmes GB. Treatment of delayed unions and non unions of the proximal fifth metatarsal with pulsed electromagnetic fields. Foot Ankle Int. 1994;15:552–556
  19. Shereff MJ, Yang QM, Kummer FJ, et al. Vascular anatomy of the fifth metatarsal. Foot Ankle. 1991;11:350–353
  20. Smith JW, Arnoczky SP, Hersh A. The intraosseous blood supply of the fifth metatarsal: Implications for healing. Foot Ankle. 1992;13:143–152
  21. Petersen WJ, Lankes JM, Paulsen F, et al. The arterial supply of the lesser metatarsal heads: A vascular injection study in human cadavers. Foot Ankle Int. 2002;23:491–495
  22. Ruedi TP, Murphy WM. Principles of Fracture Management. In: Stuttgart: Thieme; 2000;p. 368–369

PII: S1060-1872(09)00059-8

doi: 10.1053/j.otsm.2009.04.001

Operative Techniques in Sports Medicine
Volume 17, Issue 2 , Pages 119-124 , April 2009

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