Journal article
Treatment of Zone 1 Fractures of the Proximal Fifth Metatarsal With CAM-Walker Boot vs Hard-Soled Shoes
Foot & ankle international, Vol.41(5), pp.508-512
05/01/2020
DOI: 10.1177/1071100720903259
PMID: 32020818
Abstract
Background:
Zone 1 fractures of the proximal fifth metatarsal are usually treated nonsurgically using some type of immobilization. The aim of this study was to compare clinical and functional outcomes, time to return to prior activity levels, and rate of bone healing when using a hard-soled shoe (HSS) vs a controlled ankle motion (CAM)-walker boot (CWB).
Methods:
Seventy-two consecutive patients with zone 1 fractures of the fifth metatarsal base were treated conservatively with either an HSS or CWB by 2 different providers. We included 57 women and 15 men, average age of 41.3 (range, 16-88) years. Radiographic findings, visual analog scale (VAS) for pain, and American Orthopaedic Ankle & Foot Society (AOFAS) midfoot score were assessed. Patients were followed at 4, 8, 10, 12, and 24 weeks or until asymptomatic and able to return to prior level of activities. Statistical analysis was performed using Mann-Whitney U, Fisher exact, and chi-square tests. P values Results:
Age and gender distributions were similar in both groups (P = .23 and P = .57). Patients had similar VAS and AOFAS scores after 8 (P = .34 and P = .83) and 12 (P = .87 and P = .79) weeks. Average time for bone healing was significantly faster using the CWB (7.2 weeks) when compared to the HSS (8.6 weeks) (P < .001). The average time to return to prior level of activities was similar in both groups (8.3 weeks for CWB and 9.7 weeks for HSS) (P = .11). Fracture displacement was equal in both groups, with a mean of 1.9 mm of displacement in patients using the HSS, and a mean of 1.6 mm in those using the CWB (P = .26).
Conclusion:
Zone 1 fractures of the proximal fifth metatarsal can be treated conservatively with either a hard-soled shoe or a CAM-walker boot. Even though patients treated in the CAM-walker boot demonstrated earlier signs of complete healing, similar clinical and functional results were achieved with both treatments.
Details
- Title: Subtitle
- Treatment of Zone 1 Fractures of the Proximal Fifth Metatarsal With CAM-Walker Boot vs Hard-Soled Shoes
- Creators
- Danilo Ryuko Cândido Nishikawa - Hosp Servidor Publ Municipal Sao Paulo HSPM, Dept Orthopaed Foot & Ankle Surg, Sao Paulo, SP, BrazilFernando Aires Duarte - Hospital do Servidor Público MunicipalGuilherme Honda Saito - Hospital Israelita Albert EinsteinKatrina E. Bang - University of IowaAugusto Cesar Monteiro - Hospital do Servidor Público MunicipalMarcelo Pires Prado - Hospital Israelita Albert EinsteinCesar De Cesar Netto - Univ Iowa, Dept Orthopaed & Rehabil, Iowa City, IA USA
- Resource Type
- Journal article
- Publication Details
- Foot & ankle international, Vol.41(5), pp.508-512
- Publisher
- Sage
- DOI
- 10.1177/1071100720903259
- PMID
- 32020818
- ISSN
- 1071-1007
- eISSN
- 1944-7876
- Number of pages
- 5
- Language
- English
- Date published
- 05/01/2020
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984304685102771
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