Functional Outcomes of Surgical Treatment of the Fifth Diaphyseal Metatarsal Fractures (Dancer’s Fractures). A Case-Series and a Literature Review
Grigorios Kastanis1*, Kapsetakis P1, Magarakis G11, Stavrakakis MI1 and Pantouvaki A2
1Department of Orthopaedic, General Hospital of Heraklion-Venizeleio, Crete, Greece
2Department of Physiotherapy, General Hospital of Heraklion-Venizeleio, Crete, Greece
*Corresponding Author: Grigorios Kastanis, Department of Orthopaedic, General Hospital of Heraklion-Venizeleio, Crete, Greece.
July 26, 2021; Published: August 04, 2021
Introduction: Fifth metatarsal fractures represent a significant proportion of injuries, while fractures of the distal diaphyses (dancer fractures) comprise 20% of all fifth metatarsal fractures. Conservative treatment is the preferred method for managing these fractures. The aim of this study is to present our functional outcomes of patients, in long term (one year), who underwent surgical treatment with low profile plates and to analyze the time of fracture union, the complications and final patient satisfaction.
Material and Method: A retrospective study was performed from January 2015 to November 2019 with forty one patients undergone surgical treatment with low profile locking plates 2,3 mm or screws for an unstable (spiral or oblique) fracture of distal diaphyses of 5th metatarsal. The data collected, consisted of patient demographics, radiographic healing times, fracture characteristics, complications and final patients’ satisfaction (AOFAS Ankle-Hindfoot scale). Fractures were classified into two types according to the anatomical location: Type I which is a long oblique fracture that begins distal to lateral surface of metatarsal neck and extends into diaphysis (23 cases 56,1%), and type II which is when the fracture line starts at the distal-lateral metaphysis and extends proximal as spiral pattern (18 cases 43,9%).
Results: Twelve men and twenty nine females were assessed post-surgically with a mean follow-up of 16,2 months. Time to union in all fractures was 7,2 ± 2,9 weeks more specifically in type I the union (6,1 ± 1,1) was more quick than type II (7,9 ± 1,3). Complications encountered were in three cases a delay union, in four cases infection and one with malunion. At final examination the AOFAS Ankle -Hindfoot scale was for the type I, 91,5 (range 89 - 93) and for the type II, 89,7 (range 85 - 91). None of the patients presented at last examination with metatarsalgia and the implants were not removed in any patient.
Conclusion: Based on our results we postulate that open reduction and internal fixation of Dancer fractures offer high incidence of union, low rate of complications and should be considered as the ideal management for patients who need rapid reintegration into their previous activities.
Keywords: Dancer’s Fracture; Fifth Metatarsal; Outcomes; Surgical Treatment; Complications
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