Podcast
Questions and Answers
Which ligamentous connection does the fifth metatarsal base NOT have?
Which ligamentous connection does the fifth metatarsal base NOT have?
- Cuboid proximally
- Navicular distally (correct)
- Strong ligamentous attachments to both
- Fourth metatarsal base medially
What is primarily responsible for the vascular supply of the fifth metatarsal?
What is primarily responsible for the vascular supply of the fifth metatarsal?
- Quadriceps venous supply
- Dorsal and plantar metatarsal arteries (correct)
- Anterior tibial artery
- Thigh arteries
Which type of fracture is least associated with the fifth metatarsal neck?
Which type of fracture is least associated with the fifth metatarsal neck?
- Transverse fracture
- Comminuted fracture
- Complete fracture (correct)
- Butterfly fragment fracture
What is a major concern regarding fractures at the base of the fifth metatarsal?
What is a major concern regarding fractures at the base of the fifth metatarsal?
What type of injury mechanism is primarily associated with fifth metatarsal avulsion fractures?
What type of injury mechanism is primarily associated with fifth metatarsal avulsion fractures?
Which structure was traditionally thought to cause avulsion fractures of the fifth metatarsal?
Which structure was traditionally thought to cause avulsion fractures of the fifth metatarsal?
Which type of fracture is most likely to present with significant comminution?
Which type of fracture is most likely to present with significant comminution?
What has recent research implicated as a potential cause of fifth metatarsal avulsion fractures?
What has recent research implicated as a potential cause of fifth metatarsal avulsion fractures?
What is the primary goal of using external fixation in cases of significant comminution of the first metatarsal?
What is the primary goal of using external fixation in cases of significant comminution of the first metatarsal?
In the case of intra-articular first metatarsal head fractures, what is mandated if joint incongruity is noted?
In the case of intra-articular first metatarsal head fractures, what is mandated if joint incongruity is noted?
Which of the following complications can arise from first metatarsal fractures?
Which of the following complications can arise from first metatarsal fractures?
What treatment is typically indicated for nondisplaced or minimally displaced fractures of the central metatarsals?
What treatment is typically indicated for nondisplaced or minimally displaced fractures of the central metatarsals?
Which technique may be employed in cases of significant impaction of metatarsal head fractures?
Which technique may be employed in cases of significant impaction of metatarsal head fractures?
What aspect may influence the incidence of arthrosis following fractures involving joints?
What aspect may influence the incidence of arthrosis following fractures involving joints?
In cases where solid fixation of a comminuted fracture at the metatarsal base cannot be accomplished, what method might a surgeon consider?
In cases where solid fixation of a comminuted fracture at the metatarsal base cannot be accomplished, what method might a surgeon consider?
Why is it uncommon for nonunion to occur after a first metatarsal fracture?
Why is it uncommon for nonunion to occur after a first metatarsal fracture?
Which of the following surgical treatments is NOT mentioned for addressing nonunion of fractures?
Which of the following surgical treatments is NOT mentioned for addressing nonunion of fractures?
What is a common complication associated with intramedullary screw fixation of fifth metatarsals?
What is a common complication associated with intramedullary screw fixation of fifth metatarsals?
Which statement about the guidewire placement for intramedullary screw fixation is correct?
Which statement about the guidewire placement for intramedullary screw fixation is correct?
What anatomical feature should the guidewire ideally engage when entering the styloid process?
What anatomical feature should the guidewire ideally engage when entering the styloid process?
What is the recommended initial incision location for intramedullary screw fixation?
What is the recommended initial incision location for intramedullary screw fixation?
Which of the following is an important consideration during medullary curettage and bone grafting?
Which of the following is an important consideration during medullary curettage and bone grafting?
What should be ensured after placing the guidewire during the procedure?
What should be ensured after placing the guidewire during the procedure?
What is the purpose of assessing the alignment of the guidewire with fluoroscopy during surgery?
What is the purpose of assessing the alignment of the guidewire with fluoroscopy during surgery?
What complication is the most common after closed treatment of central metatarsal fractures?
What complication is the most common after closed treatment of central metatarsal fractures?
What is NOT a typical outcome when a nonunion occurs in a central metatarsal fracture?
What is NOT a typical outcome when a nonunion occurs in a central metatarsal fracture?
Which treatment method is commonly employed for managing central metatarsal fractures?
Which treatment method is commonly employed for managing central metatarsal fractures?
What is the likely reason for the low concern regarding nonunion in central metatarsal fractures?
What is the likely reason for the low concern regarding nonunion in central metatarsal fractures?
In the context of fracture fixation, what technique may be particularly challenging for central metatarsal fractures?
In the context of fracture fixation, what technique may be particularly challenging for central metatarsal fractures?
What does disruption of the metatarsal parabola indicate in a clinical scenario?
What does disruption of the metatarsal parabola indicate in a clinical scenario?
What type of fractures are described as potentially amenable to interfragmentary screw fixation?
What type of fractures are described as potentially amenable to interfragmentary screw fixation?
What factor primarily contributes to the maintenance of alignment in the third metatarsal during fracture fixation?
What factor primarily contributes to the maintenance of alignment in the third metatarsal during fracture fixation?
What is the most common type of metatarsal fracture?
What is the most common type of metatarsal fracture?
Which factor is considered paramount for the treatment of first metatarsal fractures?
Which factor is considered paramount for the treatment of first metatarsal fractures?
What kind of complications are little known regarding central metatarsal fractures?
What kind of complications are little known regarding central metatarsal fractures?
Which metatarsal fractures have controversy regarding their proper treatment?
Which metatarsal fractures have controversy regarding their proper treatment?
What is a common outcome expected when surgical intervention is implemented for metatarsal fractures?
What is a common outcome expected when surgical intervention is implemented for metatarsal fractures?
What can disruption in the metatarsal parabola cause?
What can disruption in the metatarsal parabola cause?
Which metatarsal fractures are likely to be amenable to conservative treatment?
Which metatarsal fractures are likely to be amenable to conservative treatment?
What is a concerning factor for central metatarsal fractures that must be monitored?
What is a concerning factor for central metatarsal fractures that must be monitored?
What is the primary focus of the study mentioned by Konkel et al. in 2005?
What is the primary focus of the study mentioned by Konkel et al. in 2005?
Which method is analyzed by Larson et al. in 2002 regarding Jones fractures?
Which method is analyzed by Larson et al. in 2002 regarding Jones fractures?
What was the main finding of Horst et al. in their 2004 study?
What was the main finding of Horst et al. in their 2004 study?
What innovative fixation system did Nunley and Glisson propose for Jones fractures?
What innovative fixation system did Nunley and Glisson propose for Jones fractures?
What aspect did Moshirfar et al. study in their 2003 investigation?
What aspect did Moshirfar et al. study in their 2003 investigation?
What conclusion was reached in the retrospective review of Lombardi et al. regarding the management of acute Jones fractures?
What conclusion was reached in the retrospective review of Lombardi et al. regarding the management of acute Jones fractures?
What treatment option is evaluated by Sarimo et al. for fractures located in the junction of the proximal metaphysis and diaphysis of the fifth metatarsal?
What treatment option is evaluated by Sarimo et al. for fractures located in the junction of the proximal metaphysis and diaphysis of the fifth metatarsal?
Which fixation technique was investigated by Koslowsky et al. in their 2010 study on displaced proximal fifth metatarsal fractures?
Which fixation technique was investigated by Koslowsky et al. in their 2010 study on displaced proximal fifth metatarsal fractures?
What is the commonly acceptable level of angulation for fractures in the metatarsals?
What is the commonly acceptable level of angulation for fractures in the metatarsals?
What plane experiences the least tolerance for displacement in metatarsal fractures?
What plane experiences the least tolerance for displacement in metatarsal fractures?
Which treatment method is generally appropriate for maintaining alignment in central metatarsal fractures?
Which treatment method is generally appropriate for maintaining alignment in central metatarsal fractures?
What complication can arise from transverse plane malalignment of the metatarsals?
What complication can arise from transverse plane malalignment of the metatarsals?
In the context of closed manipulation for metatarsal fractures, what may be necessary if reduction is difficult to maintain?
In the context of closed manipulation for metatarsal fractures, what may be necessary if reduction is difficult to maintain?
What is a common method used for percutaneous pinning in metatarsal fractures?
What is a common method used for percutaneous pinning in metatarsal fractures?
What specific detail is crucial for healing in metatarsal fractures?
What specific detail is crucial for healing in metatarsal fractures?
What is typically the common outcome when treating central metatarsal fractures surgically?
What is typically the common outcome when treating central metatarsal fractures surgically?
What percentage of third metatarsal fractures also involves adjacent metatarsals?
What percentage of third metatarsal fractures also involves adjacent metatarsals?
Which ligament stabilizes the second metatarsal along with the cuneiform bones?
Which ligament stabilizes the second metatarsal along with the cuneiform bones?
What is the primary mechanism of injury leading to central metatarsal fractures?
What is the primary mechanism of injury leading to central metatarsal fractures?
Why can the first metatarsal move independently from the second metatarsal?
Why can the first metatarsal move independently from the second metatarsal?
What distinguishes the fifth metatarsal's anatomical features from the central metatarsals?
What distinguishes the fifth metatarsal's anatomical features from the central metatarsals?
What type of forces primarily cause fractures in the central metatarsals?
What type of forces primarily cause fractures in the central metatarsals?
In which part of the foot does the primary nutrient artery of the central metatarsals enter?
In which part of the foot does the primary nutrient artery of the central metatarsals enter?
What percentage of all metatarsal fractures does the fifth metatarsal account for?
What percentage of all metatarsal fractures does the fifth metatarsal account for?
What was the mean time to return to activity for the failure group after metatarsal fractures?
What was the mean time to return to activity for the failure group after metatarsal fractures?
What size of cannulated screws was primarily used in the patients who sustained refractures?
What size of cannulated screws was primarily used in the patients who sustained refractures?
Which factors are considered when selecting the appropriate size of screw for metatarsal fractures?
Which factors are considered when selecting the appropriate size of screw for metatarsal fractures?
What is the minimum duration of normal weight-bearing activity required before any exercise activity may commence after a fracture?
What is the minimum duration of normal weight-bearing activity required before any exercise activity may commence after a fracture?
What complication did the study by Mologne and colleagues find to be significantly lower in the surgical group compared to the casting group?
What complication did the study by Mologne and colleagues find to be significantly lower in the surgical group compared to the casting group?
What is the typical screw size used when the medullary canal allows for a larger size?
What is the typical screw size used when the medullary canal allows for a larger size?
What complication may arise from the use of excessively long screws during surgery?
What complication may arise from the use of excessively long screws during surgery?
Which surgical method has become the most common treatment for junctional fractures of the fifth metatarsal?
Which surgical method has become the most common treatment for junctional fractures of the fifth metatarsal?
What has increased caution regarding the use of computed tomographic (CT) evaluation for fractures?
What has increased caution regarding the use of computed tomographic (CT) evaluation for fractures?
Which size screw is occasionally used in smaller patients with lower activity levels?
Which size screw is occasionally used in smaller patients with lower activity levels?
What is a key finding regarding union rates following intramedullary screw fixation for fifth metatarsal fractures?
What is a key finding regarding union rates following intramedullary screw fixation for fifth metatarsal fractures?
How many threads should ideally be engaged in the inner cortices of the bone during screw fixation?
How many threads should ideally be engaged in the inner cortices of the bone during screw fixation?
What percentage of casting patients in Mologne's trial were considered treatment failures?
What percentage of casting patients in Mologne's trial were considered treatment failures?
What is a significant concern when selecting screw size for a patient with an unusually curved metatarsal?
What is a significant concern when selecting screw size for a patient with an unusually curved metatarsal?
What type of treatment might still be necessary in cases with complete medullary obliteration?
What type of treatment might still be necessary in cases with complete medullary obliteration?
What outcome is typically associated with using intramedullary screw fixation as opposed to casting for fractures?
What outcome is typically associated with using intramedullary screw fixation as opposed to casting for fractures?
What is a common healing approach for a nondisplaced fifth metatarsal neck fracture?
What is a common healing approach for a nondisplaced fifth metatarsal neck fracture?
Which complication is least likely to occur with metatarsal fractures that do not involve articulations?
Which complication is least likely to occur with metatarsal fractures that do not involve articulations?
What complication is associated with the surgical intervention of fifth metatarsal fractures?
What complication is associated with the surgical intervention of fifth metatarsal fractures?
What is a significant risk when using dorsal incision placement for metatarsal surgeries?
What is a significant risk when using dorsal incision placement for metatarsal surgeries?
What type of surgical fixation is considered less common for fifth metatarsal fractures?
What type of surgical fixation is considered less common for fifth metatarsal fractures?
What outcome might be expected as a result of malunion in fifth metatarsal fractures?
What outcome might be expected as a result of malunion in fifth metatarsal fractures?
What is typically easier to address: prevention of complications or treatment after they arise?
What is typically easier to address: prevention of complications or treatment after they arise?
Which type of metaphyseal injury could necessitate surgical intervention or revision surgery?
Which type of metaphyseal injury could necessitate surgical intervention or revision surgery?
What is a common characteristic of the fifth metatarsal fractures in terms of treatment?
What is a common characteristic of the fifth metatarsal fractures in terms of treatment?
What does disruption in the metatarsal parabola primarily signify?
What does disruption in the metatarsal parabola primarily signify?
Why is anatomic alignment critical for the first metatarsal?
Why is anatomic alignment critical for the first metatarsal?
Which type of metatarsal fracture is known to have the highest chance of union?
Which type of metatarsal fracture is known to have the highest chance of union?
What is a significant risk factor associated with junctional fifth metatarsal fractures?
What is a significant risk factor associated with junctional fifth metatarsal fractures?
In the management of metatarsal fractures, which approach has shown to yield good outcomes when surgical intervention is necessary?
In the management of metatarsal fractures, which approach has shown to yield good outcomes when surgical intervention is necessary?
What can be a potential long-term consequence of improper treatment for metatarsal fractures?
What can be a potential long-term consequence of improper treatment for metatarsal fractures?
What characterizes the treatment of central metatarsal fractures compared to other types?
What characterizes the treatment of central metatarsal fractures compared to other types?
What is a distinguishing feature between Jones fractures and proximal diaphyseal stress fractures?
What is a distinguishing feature between Jones fractures and proximal diaphyseal stress fractures?
In children, what anatomical structure can sometimes be confused with a fifth metatarsal fracture?
In children, what anatomical structure can sometimes be confused with a fifth metatarsal fracture?
Which radiographic feature indicates a fracture with delayed union?
Which radiographic feature indicates a fracture with delayed union?
What role does the lateral band of the plantar aponeurosis play in fifth metatarsal fractures?
What role does the lateral band of the plantar aponeurosis play in fifth metatarsal fractures?
What is the likely cause of an acute-on-chronic injury in the fifth metatarsal?
What is the likely cause of an acute-on-chronic injury in the fifth metatarsal?
How can the presence of prodromal symptoms assist in diagnosis?
How can the presence of prodromal symptoms assist in diagnosis?
Which factor is critical in distinguishing acute injuries from chronic fractures in imaging?
Which factor is critical in distinguishing acute injuries from chronic fractures in imaging?
What potential pathology can be indicated by signs of a chronic fracture despite an acute injury?
What potential pathology can be indicated by signs of a chronic fracture despite an acute injury?
What factor is crucial for maintaining the alignment of the first metatarsal during treatment?
What factor is crucial for maintaining the alignment of the first metatarsal during treatment?
What is the most common type of metatarsal fracture that occurs?
What is the most common type of metatarsal fracture that occurs?
What type of complications are little known concerning central metatarsal fractures?
What type of complications are little known concerning central metatarsal fractures?
What is the consequence of disruption in the metatarsal parabola?
What is the consequence of disruption in the metatarsal parabola?
What treatment method is most likely employed for patients with nondisplaced fractures of the central metatarsals?
What treatment method is most likely employed for patients with nondisplaced fractures of the central metatarsals?
Which metatarsal fracture type still exhibits controversy regarding standard treatment approaches?
Which metatarsal fracture type still exhibits controversy regarding standard treatment approaches?
What outcome can patients and surgeons typically expect when surgical intervention is required for metatarsal fractures?
What outcome can patients and surgeons typically expect when surgical intervention is required for metatarsal fractures?
What anatomical feature contributes to the overall function of the foot and is thus important to align properly during metatarsal treatment?
What anatomical feature contributes to the overall function of the foot and is thus important to align properly during metatarsal treatment?
What is a common complication following surgical intervention for fifth metatarsal fractures?
What is a common complication following surgical intervention for fifth metatarsal fractures?
In evaluating the stability of a Jones fracture, which fixation method has shown varied outcomes based on screw size?
In evaluating the stability of a Jones fracture, which fixation method has shown varied outcomes based on screw size?
Which anatomical structure is critical for the proper healing of proximal fifth metatarsal fractures?
Which anatomical structure is critical for the proper healing of proximal fifth metatarsal fractures?
Which characteristic of the Jones fracture typically complicates its treatment?
Which characteristic of the Jones fracture typically complicates its treatment?
What is cited as a significant factor influencing surgical outcomes for athletes with fifth metatarsal fractures?
What is cited as a significant factor influencing surgical outcomes for athletes with fifth metatarsal fractures?
What type of imaging is crucial for accurately diagnosing complications in fifth metatarsal fractures?
What type of imaging is crucial for accurately diagnosing complications in fifth metatarsal fractures?
During the assessment of fifth metatarsal fractures, what factor is considered critical in determining the surgical approach?
During the assessment of fifth metatarsal fractures, what factor is considered critical in determining the surgical approach?
What is a common anatomical variation that may affect the treatment of fractures in the fifth metatarsal?
What is a common anatomical variation that may affect the treatment of fractures in the fifth metatarsal?
What is the maximum tolerable displacement in any plane for metatarsal fractures?
What is the maximum tolerable displacement in any plane for metatarsal fractures?
In which plane is displacement the least tolerated for metatarsal fractures?
In which plane is displacement the least tolerated for metatarsal fractures?
What is a potential consequence of dorsally angulated fractures?
What is a potential consequence of dorsally angulated fractures?
What technique is commonly used for closed manipulation of central metatarsal fractures?
What technique is commonly used for closed manipulation of central metatarsal fractures?
Which of the following is NOT a common treatment for maintaining reduction in metatarsal fractures?
Which of the following is NOT a common treatment for maintaining reduction in metatarsal fractures?
What is a major challenge when using distal traction for closed manipulation of significant fractures?
What is a major challenge when using distal traction for closed manipulation of significant fractures?
What characteristic is often used to determine the treatment goal for metatarsal fractures?
What characteristic is often used to determine the treatment goal for metatarsal fractures?
What complication might arise from transverse plane malalignment of metatarsal fractures?
What complication might arise from transverse plane malalignment of metatarsal fractures?
What complication is most commonly associated with closed treatment of metatarsal fractures?
What complication is most commonly associated with closed treatment of metatarsal fractures?
What was the primary finding regarding the treatment of acute Jones fractures in the randomized controlled clinical trial mentioned?
What was the primary finding regarding the treatment of acute Jones fractures in the randomized controlled clinical trial mentioned?
What is a major advantage of tension band fixation compared to other fixation methods for fifth metatarsal fractures?
What is a major advantage of tension band fixation compared to other fixation methods for fifth metatarsal fractures?
What is the recommended duration of normal weight-bearing activity before exercise can begin post-fracture?
What is the recommended duration of normal weight-bearing activity before exercise can begin post-fracture?
When is surgical intervention typically warranted for a fifth metatarsal fracture?
When is surgical intervention typically warranted for a fifth metatarsal fracture?
What characteristic of the fifth metatarsal shaft complicates interfragmentary fixation?
What characteristic of the fifth metatarsal shaft complicates interfragmentary fixation?
What surgical treatment is currently most commonly performed for junctional fractures?
What surgical treatment is currently most commonly performed for junctional fractures?
What are the outcomes reported after intramedullary screw fixation for fifth metatarsal fractures?
What are the outcomes reported after intramedullary screw fixation for fifth metatarsal fractures?
What was demonstrated to be a significant finding in the cadaveric study comparing lag screw fixation to intramedullary screw fixation?
What was demonstrated to be a significant finding in the cadaveric study comparing lag screw fixation to intramedullary screw fixation?
What caution is recommended regarding the use of CT evaluations before implementing athletic activity?
What caution is recommended regarding the use of CT evaluations before implementing athletic activity?
Which condition can typically be tolerated more easily in the fifth metatarsal compared to other metatarsals?
Which condition can typically be tolerated more easily in the fifth metatarsal compared to other metatarsals?
What is a known risk associated with larger screws when fixing avulsion fractures of the fifth metatarsal?
What is a known risk associated with larger screws when fixing avulsion fractures of the fifth metatarsal?
What treatment outcome was observed for the cast group in the comparison study of Jones fracture treatments?
What treatment outcome was observed for the cast group in the comparison study of Jones fracture treatments?
In cases of nonunion or delayed union treated surgically, what additional procedure may still be performed?
In cases of nonunion or delayed union treated surgically, what additional procedure may still be performed?
In the evaluation of fifth metatarsal fractures, what factors should be assessed to determine the severity?
In the evaluation of fifth metatarsal fractures, what factors should be assessed to determine the severity?
What characteristic is commonly observed in the fracture pattern of the fifth metatarsal shaft?
What characteristic is commonly observed in the fracture pattern of the fifth metatarsal shaft?
What is the most common location for fractures of the fifth metatarsal?
What is the most common location for fractures of the fifth metatarsal?
Which factor is believed to contribute to the slow healing of Jones fractures?
Which factor is believed to contribute to the slow healing of Jones fractures?
What has shifted in recommendations for treating Jones fractures in active populations?
What has shifted in recommendations for treating Jones fractures in active populations?
In conservative treatment of Jones fractures, which approach is typically employed?
In conservative treatment of Jones fractures, which approach is typically employed?
What mechanical issue contributes to the occurrence of stress fractures in the fifth metatarsal area?
What mechanical issue contributes to the occurrence of stress fractures in the fifth metatarsal area?
What factor is primarily responsible for the maintenance of alignment in central metatarsal fractures?
What factor is primarily responsible for the maintenance of alignment in central metatarsal fractures?
Which patient population has traditionally been recommended surgical treatment for Jones fractures?
Which patient population has traditionally been recommended surgical treatment for Jones fractures?
What is the most common complication that can arise from closed treatment of central metatarsal fractures?
What is the most common complication that can arise from closed treatment of central metatarsal fractures?
What is often the initial conservative management for a Jones fracture?
What is often the initial conservative management for a Jones fracture?
What location in the fifth metatarsal is noted for having a limited vascular supply?
What location in the fifth metatarsal is noted for having a limited vascular supply?
Why might nonunion be rarely a concern in central metatarsal fractures?
Why might nonunion be rarely a concern in central metatarsal fractures?
Which surgical fixation technique is typically used for central metatarsal fractures?
Which surgical fixation technique is typically used for central metatarsal fractures?
In the case of central metatarsal fractures, what may indicate a delayed union?
In the case of central metatarsal fractures, what may indicate a delayed union?
What characterizes oblique or spiral oblique metatarsal fractures?
What characterizes oblique or spiral oblique metatarsal fractures?
What anatomical change is noted in cases of metatarsal parabola disruption?
What anatomical change is noted in cases of metatarsal parabola disruption?
What can lead to the cause of a second metatarsal fracture following tarsometatarsal joint arthrosis?
What can lead to the cause of a second metatarsal fracture following tarsometatarsal joint arthrosis?
What percentage of third metatarsal fractures occurred concurrently with fractures of the second or fourth metatarsals?
What percentage of third metatarsal fractures occurred concurrently with fractures of the second or fourth metatarsals?
What type of trauma is most commonly attributed to central metatarsal fractures?
What type of trauma is most commonly attributed to central metatarsal fractures?
Which metatarsal is recognized for having a proximal tuberosity for tendon insertion?
Which metatarsal is recognized for having a proximal tuberosity for tendon insertion?
Which ligament provides stabilization to the second metatarsal?
Which ligament provides stabilization to the second metatarsal?
What is the most frequently fractured metatarsal?
What is the most frequently fractured metatarsal?
What is the primary source of blood supply to the central metatarsals?
What is the primary source of blood supply to the central metatarsals?
In relation to the motion of the first and second metatarsal, what characterizes their function?
In relation to the motion of the first and second metatarsal, what characterizes their function?
What is a characteristic feature of central metatarsal fractures regarding soft tissue and joint stability?
What is a characteristic feature of central metatarsal fractures regarding soft tissue and joint stability?
What is the primary concern when managing Jones fractures at the base of the fifth metatarsal?
What is the primary concern when managing Jones fractures at the base of the fifth metatarsal?
Which characteristic distinguishes acute fractures of the fifth metatarsal from stress fractures?
Which characteristic distinguishes acute fractures of the fifth metatarsal from stress fractures?
What factor could contribute to nonunion in fractures of the first metatarsal?
What factor could contribute to nonunion in fractures of the first metatarsal?
Which biomechanical feature of the fifth metatarsal is crucial for understanding its fracture types and treatment approaches?
Which biomechanical feature of the fifth metatarsal is crucial for understanding its fracture types and treatment approaches?
Which of the following conditions is often monitored when treating central metatarsal fractures?
Which of the following conditions is often monitored when treating central metatarsal fractures?
In the context of surgical treatment for fifth metatarsal fractures, what complication is most commonly associated with intramedullary screw fixation?
In the context of surgical treatment for fifth metatarsal fractures, what complication is most commonly associated with intramedullary screw fixation?
What classification pertains to fractures of the base of the fifth metatarsal?
What classification pertains to fractures of the base of the fifth metatarsal?
What methodology can be crucial in evaluating the alignment of the guidewire during surgical fixation?
What methodology can be crucial in evaluating the alignment of the guidewire during surgical fixation?
What is the typical expected outcome when conservative treatment is applied to fractures of the fifth metatarsal?
What is the typical expected outcome when conservative treatment is applied to fractures of the fifth metatarsal?
Which statement is accurate regarding the first metatarsal's anatomical significance?
Which statement is accurate regarding the first metatarsal's anatomical significance?
What potential outcome may arise from neglecting disruption in the metatarsal parabola?
What potential outcome may arise from neglecting disruption in the metatarsal parabola?
What characterizes central metatarsal fractures in terms of healing?
What characterizes central metatarsal fractures in terms of healing?
Which aspect complicates the treatment of junctional fifth metatarsal fractures?
Which aspect complicates the treatment of junctional fifth metatarsal fractures?
Which factor is most likely to contribute to long-term complications after a metatarsal fracture?
Which factor is most likely to contribute to long-term complications after a metatarsal fracture?
What is a common characteristic of the fifth metatarsal fractures?
What is a common characteristic of the fifth metatarsal fractures?
What does the literature suggest about the variety of attitudes toward metatarsal fractures treatment?
What does the literature suggest about the variety of attitudes toward metatarsal fractures treatment?
What is the primary concern when managing a Jones fracture of the fifth metatarsal?
What is the primary concern when managing a Jones fracture of the fifth metatarsal?
Which fixation method has been evaluated as a common treatment for acute Jones fractures?
Which fixation method has been evaluated as a common treatment for acute Jones fractures?
What common complication arises from surgical fixation of fifth metatarsal fractures?
What common complication arises from surgical fixation of fifth metatarsal fractures?
During the assessment of a proximal fifth metatarsal fracture, which anatomical consideration is crucial?
During the assessment of a proximal fifth metatarsal fracture, which anatomical consideration is crucial?
What aspect is particularly challenging when treating displaced proximal fifth metatarsal fractures?
What aspect is particularly challenging when treating displaced proximal fifth metatarsal fractures?
What is an innovative fixation system proposed for managing Jones fractures?
What is an innovative fixation system proposed for managing Jones fractures?
What tends to be a preferred treatment option for nondisplaced fractures of the fifth metatarsal?
What tends to be a preferred treatment option for nondisplaced fractures of the fifth metatarsal?
Which study analyzed early screw fixation versus casting in the treatment of Jones fractures?
Which study analyzed early screw fixation versus casting in the treatment of Jones fractures?
What is the commonly acceptable level of translation for metatarsal fractures?
What is the commonly acceptable level of translation for metatarsal fractures?
What is the least tolerated plane for displacement in metatarsal fractures?
What is the least tolerated plane for displacement in metatarsal fractures?
Which technique is commonly used for pinning when maintaining fracture reduction is challenging?
Which technique is commonly used for pinning when maintaining fracture reduction is challenging?
What is a common complication that can arise from close abutment of the metatarsal heads?
What is a common complication that can arise from close abutment of the metatarsal heads?
What is a critical concern with dorsally angulated fractures?
What is a critical concern with dorsally angulated fractures?
Which feature is essential to ensure healing occurs in metatarsal fractures?
Which feature is essential to ensure healing occurs in metatarsal fractures?
In what scenario may percutaneous pinning be warranted?
In what scenario may percutaneous pinning be warranted?
What typically makes frontal plane malalignment less of a concern in metatarsal fractures?
What typically makes frontal plane malalignment less of a concern in metatarsal fractures?
What defines a Jones fracture in terms of its anatomical location?
What defines a Jones fracture in terms of its anatomical location?
Which factor is noted as a possible predisposing condition for Jones fractures?
Which factor is noted as a possible predisposing condition for Jones fractures?
What typical complication is associated with fractures at the base of the first metatarsal?
What typical complication is associated with fractures at the base of the first metatarsal?
What mechanism is commonly associated with Jones fractures?
What mechanism is commonly associated with Jones fractures?
What is a significant consequence of considerable displacement in first metatarsal fractures?
What is a significant consequence of considerable displacement in first metatarsal fractures?
What feature is commonly evaluated in the case of nonunion of central metatarsal fractures?
What feature is commonly evaluated in the case of nonunion of central metatarsal fractures?
Why must treatment of first metatarsal fractures be approached with strict attention to detail?
Why must treatment of first metatarsal fractures be approached with strict attention to detail?
What might be observed on a radiograph that indicates previous injury before a metatarsal fracture?
What might be observed on a radiograph that indicates previous injury before a metatarsal fracture?
What is a significant disadvantage of percutaneous pinning techniques for metatarsal fractures?
What is a significant disadvantage of percutaneous pinning techniques for metatarsal fractures?
What is the purpose of dorsiflexing the toe during minimally invasive surgical procedures for metatarsal fractures?
What is the purpose of dorsiflexing the toe during minimally invasive surgical procedures for metatarsal fractures?
What anatomical feature is primarily disrupted when using percutaneous intramedullary fixation methods?
What anatomical feature is primarily disrupted when using percutaneous intramedullary fixation methods?
What advantage does standard open reduction with internal fixation provide over minimally invasive methods?
What advantage does standard open reduction with internal fixation provide over minimally invasive methods?
Minimally invasive techniques for metatarsal fractures aim to achieve which of the following?
Minimally invasive techniques for metatarsal fractures aim to achieve which of the following?
What is an essential consideration when deciding on a surgical approach for metatarsal fractures?
What is an essential consideration when deciding on a surgical approach for metatarsal fractures?
Which surgical technique may involve a risk of disrupting the soft tissue envelope around the fracture site?
Which surgical technique may involve a risk of disrupting the soft tissue envelope around the fracture site?
What is a primary reason for the potential long-term risks associated with the described surgical methods?
What is a primary reason for the potential long-term risks associated with the described surgical methods?
What was the failure cycle count for the cannulated titanium screw in the study comparing different screw types?
What was the failure cycle count for the cannulated titanium screw in the study comparing different screw types?
Which type of screw showed the highest strength according to the comparison study involving different screw types?
Which type of screw showed the highest strength according to the comparison study involving different screw types?
What was the mean time to return to activity in the failure group after treatment?
What was the mean time to return to activity in the failure group after treatment?
What was the general recommendation for treating fifth metatarsal fractures when time to return to full activities is not critical?
What was the general recommendation for treating fifth metatarsal fractures when time to return to full activities is not critical?
Which factor is NOT mentioned as significant when determining screw size for fixation?
Which factor is NOT mentioned as significant when determining screw size for fixation?
Which type of screw was specifically developed for Jones fracture fixation, according to one study?
Which type of screw was specifically developed for Jones fracture fixation, according to one study?
What diameter screw is most commonly used when appropriate in fixation for metatarsal fractures?
What diameter screw is most commonly used when appropriate in fixation for metatarsal fractures?
What was a major finding regarding the number of cycles to failure and screw size in the study conducted by Reese and colleagues?
What was a major finding regarding the number of cycles to failure and screw size in the study conducted by Reese and colleagues?
What complication has been reported in patients experiencing refracture after intramedullary screw fixation?
What complication has been reported in patients experiencing refracture after intramedullary screw fixation?
What complication was noted in the study by Larson and colleagues regarding intramedullary screw fixation for Jones fractures?
What complication was noted in the study by Larson and colleagues regarding intramedullary screw fixation for Jones fractures?
What was the reported failure rate of intramedullary screw fixation in elite athletes, according to Larson and colleagues?
What was the reported failure rate of intramedullary screw fixation in elite athletes, according to Larson and colleagues?
Why might a solid screw be preferred over a cannulated screw in certain cases?
Why might a solid screw be preferred over a cannulated screw in certain cases?
What was a significant finding related to screw size used in high-demand patient populations?
What was a significant finding related to screw size used in high-demand patient populations?
Which of the following screws exhibited the lowest cycle to failure according to the study by Reese and colleagues?
Which of the following screws exhibited the lowest cycle to failure according to the study by Reese and colleagues?
What characteristic must all threads of the screw ideally achieve relative to the fracture site?
What characteristic must all threads of the screw ideally achieve relative to the fracture site?
What consideration is essential to prevent the screw from penetrating the medial cortex?
What consideration is essential to prevent the screw from penetrating the medial cortex?
Which fixation technique is considered effective for treating Jones fractures according to Reese et al. in 2004?
Which fixation technique is considered effective for treating Jones fractures according to Reese et al. in 2004?
What aspect did Horst et al. investigate in their 2004 study regarding the treatment of Jones fractures?
What aspect did Horst et al. investigate in their 2004 study regarding the treatment of Jones fractures?
What innovative system did Nunley and Glisson introduce for the treatment of Jones fractures?
What innovative system did Nunley and Glisson introduce for the treatment of Jones fractures?
Which treatment method is utilized by Sarimo et al. for fractures located in the junction of the proximal metaphysis and diaphysis of the fifth metatarsal?
Which treatment method is utilized by Sarimo et al. for fractures located in the junction of the proximal metaphysis and diaphysis of the fifth metatarsal?
Which complication is noted in studies regarding intramedullary screw fixation of the fifth metatarsals?
Which complication is noted in studies regarding intramedullary screw fixation of the fifth metatarsals?
What fixation technique was proposed by Koslowsky et al. in their 2010 study for displaced proximal fifth metatarsal fractures?
What fixation technique was proposed by Koslowsky et al. in their 2010 study for displaced proximal fifth metatarsal fractures?
What clinical outcome is primarily assessed by Moshirfar et al. in their 2003 study related to fifth metatarsal tuberosity fractures?
What clinical outcome is primarily assessed by Moshirfar et al. in their 2003 study related to fifth metatarsal tuberosity fractures?
What finding was highlighted in the retrospective review by Lombardi et al. regarding the management of acute Jones fractures?
What finding was highlighted in the retrospective review by Lombardi et al. regarding the management of acute Jones fractures?
What percentage of all foot fractures are represented by acute metatarsal fractures?
What percentage of all foot fractures are represented by acute metatarsal fractures?
Which type of metatarsal fractures can be associated with Lisfranc dislocations?
Which type of metatarsal fractures can be associated with Lisfranc dislocations?
Which type of injury mechanism is primarily responsible for most metatarsal fractures?
Which type of injury mechanism is primarily responsible for most metatarsal fractures?
Which fractures should be evaluated for shortening, angulation, and displacement?
Which fractures should be evaluated for shortening, angulation, and displacement?
What is a common concern with high-energy crush injuries related to metatarsal fractures?
What is a common concern with high-energy crush injuries related to metatarsal fractures?
Which fracture type may progress from a stress fracture to a complete transverse fracture?
Which fracture type may progress from a stress fracture to a complete transverse fracture?
For fifth metatarsal fractures, which is a likely reason for the low concern regarding nonunion?
For fifth metatarsal fractures, which is a likely reason for the low concern regarding nonunion?
What type of metatarsal fracture is noted to typically occur in patterns of transverse or oblique fractures?
What type of metatarsal fracture is noted to typically occur in patterns of transverse or oblique fractures?
What contributes to the slow healing tendency of Jones fractures?
What contributes to the slow healing tendency of Jones fractures?
Which treatment method is commonly recommended for conservative management of Jones fractures?
Which treatment method is commonly recommended for conservative management of Jones fractures?
What anatomical feature poses a risk for motion at the fracture site when weight is applied?
What anatomical feature poses a risk for motion at the fracture site when weight is applied?
In which population is surgical treatment of Jones fractures typically recommended?
In which population is surgical treatment of Jones fractures typically recommended?
Which statement accurately describes the vascular supply of the fifth metatarsal base?
Which statement accurately describes the vascular supply of the fifth metatarsal base?
What influence does the metaphyseal-diaphyseal junction have on Jones fractures?
What influence does the metaphyseal-diaphyseal junction have on Jones fractures?
Which factor is considered when determining treatment for active individuals with Jones fractures?
Which factor is considered when determining treatment for active individuals with Jones fractures?
How does weight-bearing activities affect the fifth metatarsal during healing?
How does weight-bearing activities affect the fifth metatarsal during healing?
What is the incidence rate of first metatarsal fractures in adults?
What is the incidence rate of first metatarsal fractures in adults?
What main advantage do cannulated screws offer in the fixation of fifth metatarsal fractures?
What main advantage do cannulated screws offer in the fixation of fifth metatarsal fractures?
Which characteristic of the first metatarsal contributes to its strength and stability?
Which characteristic of the first metatarsal contributes to its strength and stability?
Which type of screw demonstrated the highest number of cycles to failure in the comparisons made?
Which type of screw demonstrated the highest number of cycles to failure in the comparisons made?
What is a common mechanism of fracture for the first metatarsal in pediatric populations?
What is a common mechanism of fracture for the first metatarsal in pediatric populations?
What was a significant concern raised in the comparison of cannulated screws versus solid screws?
What was a significant concern raised in the comparison of cannulated screws versus solid screws?
What role does the articular surface of the first metatarsal play?
What role does the articular surface of the first metatarsal play?
In the treatment failures reported by Larson and colleagues, what commonality existed among the patients affected?
In the treatment failures reported by Larson and colleagues, what commonality existed among the patients affected?
What factor was shown to increase the number of cycles to failure in screw fixation?
What factor was shown to increase the number of cycles to failure in screw fixation?
What effect can a traumatic injury to the first metatarsal have on gait?
What effect can a traumatic injury to the first metatarsal have on gait?
What outcome was NOT typically reported following intramedullary screw fixation for Jones fractures?
What outcome was NOT typically reported following intramedullary screw fixation for Jones fractures?
Which of the following statements regarding the first metatarsal is inaccurate?
Which of the following statements regarding the first metatarsal is inaccurate?
Which screw type was reported to exceed other options with regard to load cycles by a significant margin?
Which screw type was reported to exceed other options with regard to load cycles by a significant margin?
What is the primary feature of the first metatarsal's head?
What is the primary feature of the first metatarsal's head?
Which anatomical feature is significant for the first metatarsal's articulation with the medial cuneiform?
Which anatomical feature is significant for the first metatarsal's articulation with the medial cuneiform?
What is the primary issue associated with the use of cannulated screws compared to solid screws?
What is the primary issue associated with the use of cannulated screws compared to solid screws?
What typically characterizes the management of unstable distal fractures of the first metatarsal?
What typically characterizes the management of unstable distal fractures of the first metatarsal?
What is a primary concern when dealing with fractures of the first metatarsal?
What is a primary concern when dealing with fractures of the first metatarsal?
What is the suggested duration for non-weight bearing treatment following a nondisplaced first metatarsal fracture?
What is the suggested duration for non-weight bearing treatment following a nondisplaced first metatarsal fracture?
Which fixation technique is considered standard for diaphyseal fractures of the first metatarsal?
Which fixation technique is considered standard for diaphyseal fractures of the first metatarsal?
What should be prioritized during the fixation of a first metatarsal fracture?
What should be prioritized during the fixation of a first metatarsal fracture?
In which scenario is close radiographic follow-up particularly emphasized?
In which scenario is close radiographic follow-up particularly emphasized?
What common issue often arises due to significant displacement in the transverse plane of the first metatarsal?
What common issue often arises due to significant displacement in the transverse plane of the first metatarsal?
What anatomical feature is crucial to consider during the fixation of the first metatarsal fracture?
What anatomical feature is crucial to consider during the fixation of the first metatarsal fracture?
Which type of injury mechanism is primarily associated with the Jones fracture of the fifth metatarsal?
Which type of injury mechanism is primarily associated with the Jones fracture of the fifth metatarsal?
What is the primary concern regarding vascular supply in the healing of fifth metatarsal fractures?
What is the primary concern regarding vascular supply in the healing of fifth metatarsal fractures?
What is the classification of a fracture at the base of the fifth metatarsal distal to the tuberosity primarily based on?
What is the classification of a fracture at the base of the fifth metatarsal distal to the tuberosity primarily based on?
Which type of fracture is least likely to result in significant comminution in metatarsal injuries?
Which type of fracture is least likely to result in significant comminution in metatarsal injuries?
In which case may a surgical intervention be deemed necessary for fifth metatarsal fractures?
In which case may a surgical intervention be deemed necessary for fifth metatarsal fractures?
Which anatomical feature is critical for understanding the healing implications of proximal fractures in the fifth metatarsal?
Which anatomical feature is critical for understanding the healing implications of proximal fractures in the fifth metatarsal?
What is a significant complication associated with closed treatment of central metatarsal fractures?
What is a significant complication associated with closed treatment of central metatarsal fractures?
What is a common finding in biomechanical studies on fifth metatarsal fractures?
What is a common finding in biomechanical studies on fifth metatarsal fractures?
Which of the following levels of angulation is commonly accepted as acceptable for metatarsal fractures?
Which of the following levels of angulation is commonly accepted as acceptable for metatarsal fractures?
Sagittal plane displacement of fractures is the least tolerated.
Sagittal plane displacement of fractures is the least tolerated.
What is the main goal of treatment for metatarsal fractures?
What is the main goal of treatment for metatarsal fractures?
Closed manipulation of fractures of the central metatarsals can be done with __________.
Closed manipulation of fractures of the central metatarsals can be done with __________.
Match the plane of malalignment to its tolerance level in metatarsal fractures:
Match the plane of malalignment to its tolerance level in metatarsal fractures:
What condition can arise due to close abutment of the metatarsal heads?
What condition can arise due to close abutment of the metatarsal heads?
Dorsally angulated fractures do not cause irritation at the adjacent metatarsals.
Dorsally angulated fractures do not cause irritation at the adjacent metatarsals.
Percutaneous Kirschner (K)-wire pinning is often performed through the corresponding metatarsal head using a __________ fixation.
Percutaneous Kirschner (K)-wire pinning is often performed through the corresponding metatarsal head using a __________ fixation.
What percentage of third metatarsal fractures occurred concurrently with second or fourth metatarsal fractures?
What percentage of third metatarsal fractures occurred concurrently with second or fourth metatarsal fractures?
All cases of multiple metatarsal fractures can occur in non-contiguous bones.
All cases of multiple metatarsal fractures can occur in non-contiguous bones.
Which metatarsal is reported to be the most frequently fractured?
Which metatarsal is reported to be the most frequently fractured?
The second metatarsal is additionally stabilized by the _______ ligament.
The second metatarsal is additionally stabilized by the _______ ligament.
Match the following metatarsals with their unique features:
Match the following metatarsals with their unique features:
What kind of trauma is most commonly associated with central metatarsal fractures?
What kind of trauma is most commonly associated with central metatarsal fractures?
Direct trauma to the foot can include crushing blows and penetrating injuries.
Direct trauma to the foot can include crushing blows and penetrating injuries.
What is the primary nutrient artery's entry point for the central metatarsals?
What is the primary nutrient artery's entry point for the central metatarsals?
What was the mean time to return to activity in the failure group?
What was the mean time to return to activity in the failure group?
A smaller screw size is always appropriate for high-demand patient populations.
A smaller screw size is always appropriate for high-demand patient populations.
How many refractures occurred in the study after intramedullary screw fixation?
How many refractures occurred in the study after intramedullary screw fixation?
The appropriate-sized screw used is typically a ____, ____, or ____ mm screw.
The appropriate-sized screw used is typically a ____, ____, or ____ mm screw.
Match the following screws to their characteristics:
Match the following screws to their characteristics:
What factor is crucial when selecting an appropriate-sized screw?
What factor is crucial when selecting an appropriate-sized screw?
It is important for all threads of a screw to be distal to the fracture site.
It is important for all threads of a screw to be distal to the fracture site.
What type of patients sustained refractures in the study?
What type of patients sustained refractures in the study?
What is the primary goal when treating a fifth metatarsal fracture?
What is the primary goal when treating a fifth metatarsal fracture?
Tension band fixation is preferred over larger screws in treating avulsion fractures of the fifth metatarsal.
Tension band fixation is preferred over larger screws in treating avulsion fractures of the fifth metatarsal.
What type of injury is primarily responsible for avulsion fractures of the styloid process?
What type of injury is primarily responsible for avulsion fractures of the styloid process?
What is the typical non-surgical management period for fifth metatarsal fractures?
What is the typical non-surgical management period for fifth metatarsal fractures?
Avulsion fractures of the styloid process tend to heal well.
Avulsion fractures of the styloid process tend to heal well.
What is a common treatment for nondisplaced or minimally displaced avulsion fractures?
What is a common treatment for nondisplaced or minimally displaced avulsion fractures?
The technique that resulted in greater load to failure in fixing the fifth metatarsal was __________.
The technique that resulted in greater load to failure in fixing the fifth metatarsal was __________.
Match the fracture types with their characteristics:
Match the fracture types with their characteristics:
Fractures involving more than ______ mm of displacement should be considered for surgical intervention.
Fractures involving more than ______ mm of displacement should be considered for surgical intervention.
When is surgical intervention recommended for fifth metatarsal fractures?
When is surgical intervention recommended for fifth metatarsal fractures?
Match the following treatments with their corresponding fracture types:
Match the following treatments with their corresponding fracture types:
Which of the following is a recommended method of fixation for significant displacement in avulsion fractures?
Which of the following is a recommended method of fixation for significant displacement in avulsion fractures?
Interfragmentary screw fixation is always a suitable option for fifth metatarsal fractures.
Interfragmentary screw fixation is always a suitable option for fifth metatarsal fractures.
Identify a common complication associated with fifth metatarsal fractures.
Identify a common complication associated with fifth metatarsal fractures.
The insertion site of the peroneus brevis tendon is usually expansive enough to require tendon anchoring in all avulsion fractures.
The insertion site of the peroneus brevis tendon is usually expansive enough to require tendon anchoring in all avulsion fractures.
What complications should be monitored for fractures involving 30% or more of a joint?
What complications should be monitored for fractures involving 30% or more of a joint?
What is the primary treatment method for nondisplaced fifth metatarsal neck fractures?
What is the primary treatment method for nondisplaced fifth metatarsal neck fractures?
Delayed union and nonunion can lead to a need for surgical intervention.
Delayed union and nonunion can lead to a need for surgical intervention.
What type of surgical fixation is less commonly performed for fifth metatarsal fractures?
What type of surgical fixation is less commonly performed for fifth metatarsal fractures?
Complications from metatarsal fractures can include __________.
Complications from metatarsal fractures can include __________.
Match the complication of fifth metatarsal fractures with its description:
Match the complication of fifth metatarsal fractures with its description:
Which of the following is a potential consequence of malunion in a metatarsal fracture?
Which of the following is a potential consequence of malunion in a metatarsal fracture?
What can cause irritation to the sural nerve during surgical intervention of a fifth metatarsal fracture?
What can cause irritation to the sural nerve during surgical intervention of a fifth metatarsal fracture?
Most metatarsal fractures involve articulations.
Most metatarsal fractures involve articulations.
What percentage of total skeletal fractures do metatarsal fractures account for?
What percentage of total skeletal fractures do metatarsal fractures account for?
Metatarsal fractures rarely occur due to direct trauma.
Metatarsal fractures rarely occur due to direct trauma.
What is the primary concern in high-energy crush injuries related to metatarsal fractures?
What is the primary concern in high-energy crush injuries related to metatarsal fractures?
Metatarsal fractures are commonly classified into proximal metaphyseal, diaphyseal, and ________ fractures.
Metatarsal fractures are commonly classified into proximal metaphyseal, diaphyseal, and ________ fractures.
Which location is NOT typically associated with metatarsal fractures?
Which location is NOT typically associated with metatarsal fractures?
Match the following types of metatarsal fractures with their characteristics:
Match the following types of metatarsal fractures with their characteristics:
Metatarsal fractures can only occur as isolated injuries.
Metatarsal fractures can only occur as isolated injuries.
What type of metatarsal fractures are often well aligned due to articulations and soft tissue attachments?
What type of metatarsal fractures are often well aligned due to articulations and soft tissue attachments?
The first metatarsal is the longest, strongest, and heaviest of the metatarsal bones.
The first metatarsal is the longest, strongest, and heaviest of the metatarsal bones.
In which population is a higher rate of first metatarsal fractures noted?
In which population is a higher rate of first metatarsal fractures noted?
The first metatarsal articulates with the medial ____________.
The first metatarsal articulates with the medial ____________.
Match the types of metatarsal fractures with their characteristics:
Match the types of metatarsal fractures with their characteristics:
What is a common outcome associated with a traumatic disruption of the first metatarsal?
What is a common outcome associated with a traumatic disruption of the first metatarsal?
The first metatarsal is covered by articular cartilage at both ends.
The first metatarsal is covered by articular cartilage at both ends.
What is the primary injury mechanism for fractures in pediatric populations under 5 years?
What is the primary injury mechanism for fractures in pediatric populations under 5 years?
Which metatarsal fracture is most commonly associated with conservative treatment?
Which metatarsal fracture is most commonly associated with conservative treatment?
Central metatarsal fractures are known for having extensive complications.
Central metatarsal fractures are known for having extensive complications.
What is paramount regarding the treatment of first metatarsal fractures?
What is paramount regarding the treatment of first metatarsal fractures?
The ______ metatarsal is the most common type of metatarsal fracture.
The ______ metatarsal is the most common type of metatarsal fracture.
Match the following types of metatarsal fractures to their key characteristics:
Match the following types of metatarsal fractures to their key characteristics:
What consequence can disruption in the metatarsal parabola cause?
What consequence can disruption in the metatarsal parabola cause?
Surgical intervention for metatarsal fractures do not typically lead to good outcomes.
Surgical intervention for metatarsal fractures do not typically lead to good outcomes.
What is one significant factor that influences the treatment approach to metatarsal fractures?
What is one significant factor that influences the treatment approach to metatarsal fractures?
What is the typical conservative treatment for Jones fractures?
What is the typical conservative treatment for Jones fractures?
Jones fractures tend to heal quickly with minimal complications.
Jones fractures tend to heal quickly with minimal complications.
What is the most commonly encountered metatarsal fracture?
What is the most commonly encountered metatarsal fracture?
The base of the fifth metatarsal has strong ligamentous attachments to the ______ and ______.
The base of the fifth metatarsal has strong ligamentous attachments to the ______ and ______.
Which patient population is commonly recommended for surgical treatment of Jones fractures?
Which patient population is commonly recommended for surgical treatment of Jones fractures?
Match the following factors to their roles in the healing of Jones fractures:
Match the following factors to their roles in the healing of Jones fractures:
Weight-bearing activities can negatively impact healing in fractures at the fifth metatarsal.
Weight-bearing activities can negatively impact healing in fractures at the fifth metatarsal.
What duration of non-weight bearing is typically recommended for conservative treatment in Jones fractures?
What duration of non-weight bearing is typically recommended for conservative treatment in Jones fractures?
Which type of screw has been shown to have the greatest strength in the studies referenced?
Which type of screw has been shown to have the greatest strength in the studies referenced?
Cannulated screws are preferred because they provide better strength than noncannulated screws.
Cannulated screws are preferred because they provide better strength than noncannulated screws.
What is the recommended treatment option for patients with fifth metatarsal fractures when time to return to activities is not critical?
What is the recommended treatment option for patients with fifth metatarsal fractures when time to return to activities is not critical?
The ___ screw exceeded the load cycles compared to other screws by up to 7067-fold.
The ___ screw exceeded the load cycles compared to other screws by up to 7067-fold.
What issue was observed with screw fixation methods for Jones fractures?
What issue was observed with screw fixation methods for Jones fractures?
Match the type of screw with its corresponding description:
Match the type of screw with its corresponding description:
The study by Reese and colleagues demonstrated that larger screw sizes had no effect on the number of cycles to failure.
The study by Reese and colleagues demonstrated that larger screw sizes had no effect on the number of cycles to failure.
In the studies reviewed, what percentage of treatment failures occurred in elite athletes?
In the studies reviewed, what percentage of treatment failures occurred in elite athletes?
What is the primary focus of the study conducted by Kavanaugh et al. in 1978 regarding the Jones fracture?
What is the primary focus of the study conducted by Kavanaugh et al. in 1978 regarding the Jones fracture?
The study by Mologne et al. indicated that early screw fixation is less effective than casting for Jones fractures.
The study by Mologne et al. indicated that early screw fixation is less effective than casting for Jones fractures.
Name one potential complication following intramedullary screw fixation of fifth metatarsal fractures.
Name one potential complication following intramedullary screw fixation of fifth metatarsal fractures.
The anatomical feature that should engage during the guidewire placement for intramedullary screw fixation is the ______ process.
The anatomical feature that should engage during the guidewire placement for intramedullary screw fixation is the ______ process.
Match the following authors with their studies related to metatarsal fractures:
Match the following authors with their studies related to metatarsal fractures:
Which of the following is NOT a treatment option mentioned for Jones fractures?
Which of the following is NOT a treatment option mentioned for Jones fractures?
Stress fractures of the fifth metatarsal are commonly observed in athletes.
Stress fractures of the fifth metatarsal are commonly observed in athletes.
What does the term 'Jones fracture' refer to?
What does the term 'Jones fracture' refer to?
What percentage of all foot fractures do acute metatarsal fractures account for?
What percentage of all foot fractures do acute metatarsal fractures account for?
Most metatarsal fractures are caused by high-energy trauma.
Most metatarsal fractures are caused by high-energy trauma.
What is the main concern with high-energy crush injuries related to metatarsal fractures?
What is the main concern with high-energy crush injuries related to metatarsal fractures?
Metatarsal fractures are generally divided into _____, diaphyseal, and head and neck fractures.
Metatarsal fractures are generally divided into _____, diaphyseal, and head and neck fractures.
Which fractures may be associated with Lisfranc dislocations?
Which fractures may be associated with Lisfranc dislocations?
Match the type of metatarsal fracture with its common fracture pattern:
Match the type of metatarsal fracture with its common fracture pattern:
Compartment syndrome is not a concern for metatarsal fractures.
Compartment syndrome is not a concern for metatarsal fractures.
What do distal metaphyseal fractures typically experience if displacement is present?
What do distal metaphyseal fractures typically experience if displacement is present?
What is the common surgical treatment for acute fifth metatarsal fractures?
What is the common surgical treatment for acute fifth metatarsal fractures?
Early screw fixation has a higher treatment failure rate compared to casting for acute Jones fractures.
Early screw fixation has a higher treatment failure rate compared to casting for acute Jones fractures.
What is the purpose of a computed tomographic (CT) evaluation before implementing athletic activity?
What is the purpose of a computed tomographic (CT) evaluation before implementing athletic activity?
The common complication following closed treatment of metatarsal fractures is __________.
The common complication following closed treatment of metatarsal fractures is __________.
Match the treatment options with their related outcomes:
Match the treatment options with their related outcomes:
What percentage of patients in the casting group experienced treatment failures according to the study?
What percentage of patients in the casting group experienced treatment failures according to the study?
Caution is recommended with the routine use of CT due to increased radiation exposure concerns.
Caution is recommended with the routine use of CT due to increased radiation exposure concerns.
What factors are assessed clinically before implementing exercise activity after a fracture?
What factors are assessed clinically before implementing exercise activity after a fracture?
What was the highest number of cycles to failure recorded for a solid screw in the compared studies?
What was the highest number of cycles to failure recorded for a solid screw in the compared studies?
Cannulated screws are stronger than solid screws based on the cycles to failure reported.
Cannulated screws are stronger than solid screws based on the cycles to failure reported.
What type of fixation is commonly used for fifth metatarsal fractures?
What type of fixation is commonly used for fifth metatarsal fractures?
The strength of the cannulated titanium screw failed after ______ cycles.
The strength of the cannulated titanium screw failed after ______ cycles.
Match the types of screws with their reported cycles to failure:
Match the types of screws with their reported cycles to failure:
What was a significant outcome reported by Larson and colleagues regarding intramedullary screw fixation?
What was a significant outcome reported by Larson and colleagues regarding intramedullary screw fixation?
The size of screws used in intramedullary fixation ranged from 3.5 mm to 5.0 mm.
The size of screws used in intramedullary fixation ranged from 3.5 mm to 5.0 mm.
What percentage of failures in screw fixation occurred among elite athletes?
What percentage of failures in screw fixation occurred among elite athletes?
What type of fracture is associated with avulsion of the styloid process?
What type of fracture is associated with avulsion of the styloid process?
Avulsion fractures of the styloid process tend to have a poor healing tendency.
Avulsion fractures of the styloid process tend to have a poor healing tendency.
What is the recommended treatment for nondisplaced and minimally displaced fractures?
What is the recommended treatment for nondisplaced and minimally displaced fractures?
In cases of more than __ mm of displacement, surgical intervention should be considered.
In cases of more than __ mm of displacement, surgical intervention should be considered.
What should be done when displacement occurs in an avulsion fracture?
What should be done when displacement occurs in an avulsion fracture?
Match the following terms related to avulsion fractures with their definitions:
Match the following terms related to avulsion fractures with their definitions:
Nondisplaced avulsion fractures require tendon anchoring during treatment.
Nondisplaced avulsion fractures require tendon anchoring during treatment.
What is one common method of fixation mentioned for displaced avulsion fractures?
What is one common method of fixation mentioned for displaced avulsion fractures?
What percentage of fifth metatarsal fractures is reported to occur?
What percentage of fifth metatarsal fractures is reported to occur?
The second metatarsal does not articulate with any cuneiform bones.
The second metatarsal does not articulate with any cuneiform bones.
What is the major cause of central metatarsal fractures?
What is the major cause of central metatarsal fractures?
The fifth metatarsal has a proximal tuberosity for the insertion of the _______ tendon.
The fifth metatarsal has a proximal tuberosity for the insertion of the _______ tendon.
Match the metatarsals with their unique features:
Match the metatarsals with their unique features:
What type of injury is primarily associated with indirect fractures of the central metatarsals?
What type of injury is primarily associated with indirect fractures of the central metatarsals?
The first metatarsal has a strong ligamentous support connecting it to the second metatarsal.
The first metatarsal has a strong ligamentous support connecting it to the second metatarsal.
What anatomical structures primarily stabilize the bases of the central metatarsals?
What anatomical structures primarily stabilize the bases of the central metatarsals?
Which type of metatarsal fracture is acknowledged as the most common?
Which type of metatarsal fracture is acknowledged as the most common?
Central metatarsal fractures are associated with a high likelihood of union.
Central metatarsal fractures are associated with a high likelihood of union.
What is primarily crucial for the treatment of first metatarsal fractures?
What is primarily crucial for the treatment of first metatarsal fractures?
The fifth metatarsal has a high percentage of fractures that can be treated with ________ treatment.
The fifth metatarsal has a high percentage of fractures that can be treated with ________ treatment.
Which aspect can potentially cause discomfort if disrupted in the metatarsal?
Which aspect can potentially cause discomfort if disrupted in the metatarsal?
Match the fracture type with its treatment approach:
Match the fracture type with its treatment approach:
Controversy exists around the treatment of junctional fifth metatarsal fractures.
Controversy exists around the treatment of junctional fifth metatarsal fractures.
What causes significant inconvenience to patients with metatarsal fractures?
What causes significant inconvenience to patients with metatarsal fractures?
Flashcards
Fifth Metatarsal Base Articulation
Fifth Metatarsal Base Articulation
The fifth metatarsal base forms a joint with the cuboid bone above it and the fourth metatarsal bone on its inner side. It's strongly connected by ligaments to both bones.
Muscles Attaching to the Fifth Metatarsal
Muscles Attaching to the Fifth Metatarsal
The flexor digiti minimi muscle, along with the dorsal and plantar interossei muscles, all originate from the fifth metatarsal bone.
Fifth Metatarsal Blood Supply
Fifth Metatarsal Blood Supply
The fifth metatarsal receives blood supply from the dorsal metatarsal artery, the plantar metatarsal artery, and the fibular plantar marginal artery.
Fifth Metatarsal Fracture Healing Issues
Fifth Metatarsal Fracture Healing Issues
Signup and view all the flashcards
Fifth Metatarsal Fracture Classification
Fifth Metatarsal Fracture Classification
Signup and view all the flashcards
Fifth Metatarsal Neck Fractures
Fifth Metatarsal Neck Fractures
Signup and view all the flashcards
Fifth Metatarsal Shaft Fractures
Fifth Metatarsal Shaft Fractures
Signup and view all the flashcards
Fifth Metatarsal Base Fractures
Fifth Metatarsal Base Fractures
Signup and view all the flashcards
Comminuted First Metatarsal Fracture
Comminuted First Metatarsal Fracture
Signup and view all the flashcards
External Fixation for Comminuted First Metatarsal Fractures
External Fixation for Comminuted First Metatarsal Fractures
Signup and view all the flashcards
Treatment of First Metatarsal Head Fractures
Treatment of First Metatarsal Head Fractures
Signup and view all the flashcards
Complications of First Metatarsal Fractures
Complications of First Metatarsal Fractures
Signup and view all the flashcards
Treatment of Nondisplaced Central Metatarsal Fractures
Treatment of Nondisplaced Central Metatarsal Fractures
Signup and view all the flashcards
Transfer Metatarsalgia
Transfer Metatarsalgia
Signup and view all the flashcards
Primary Metatarsophalangeal Joint Arthrodesis
Primary Metatarsophalangeal Joint Arthrodesis
Signup and view all the flashcards
Open Reduction with Internal Fixation
Open Reduction with Internal Fixation
Signup and view all the flashcards
What is the metatarsal parabola?
What is the metatarsal parabola?
Signup and view all the flashcards
What happens when the metatarsal parabola is disrupted?
What happens when the metatarsal parabola is disrupted?
Signup and view all the flashcards
Why are nonunions uncommon in central metatarsal fractures?
Why are nonunions uncommon in central metatarsal fractures?
Signup and view all the flashcards
What types of forces cause central metatarsal fractures?
What types of forces cause central metatarsal fractures?
Signup and view all the flashcards
Why is screw fixation less common with central metatarsal fractures?
Why is screw fixation less common with central metatarsal fractures?
Signup and view all the flashcards
What is dorsal plate fixation?
What is dorsal plate fixation?
Signup and view all the flashcards
What is the most common complication of central metatarsal fractures?
What is the most common complication of central metatarsal fractures?
Signup and view all the flashcards
What's the difference between a delayed union and a nonunion?
What's the difference between a delayed union and a nonunion?
Signup and view all the flashcards
Metatarsal Parabola
Metatarsal Parabola
Signup and view all the flashcards
First Ray Instability
First Ray Instability
Signup and view all the flashcards
Central Metatarsal Fracture
Central Metatarsal Fracture
Signup and view all the flashcards
Open Reduction with Internal Fixation (ORIF)
Open Reduction with Internal Fixation (ORIF)
Signup and view all the flashcards
What is an avulsion fracture of the fifth metatarsal?
What is an avulsion fracture of the fifth metatarsal?
Signup and view all the flashcards
Why is intramedullary screw fixation a common treatment for a Jones fracture?
Why is intramedullary screw fixation a common treatment for a Jones fracture?
Signup and view all the flashcards
What does medullary curettage and bone grafting involve?
What does medullary curettage and bone grafting involve?
Signup and view all the flashcards
What kind of force typically causes shaft fractures of the fifth metatarsal?
What kind of force typically causes shaft fractures of the fifth metatarsal?
Signup and view all the flashcards
What is the role of fluoroscopy in intramedullary screw fixation?
What is the role of fluoroscopy in intramedullary screw fixation?
Signup and view all the flashcards
What is a nonunion in the context of a fifth metatarsal fracture?
What is a nonunion in the context of a fifth metatarsal fracture?
Signup and view all the flashcards
What are some potential complications of surgical treatments for fifth metatarsal fractures?
What are some potential complications of surgical treatments for fifth metatarsal fractures?
Signup and view all the flashcards
How is a non-displaced Jones fracture typically treated?
How is a non-displaced Jones fracture typically treated?
Signup and view all the flashcards
What makes Jones fractures difficult to treat?
What makes Jones fractures difficult to treat?
Signup and view all the flashcards
How are Jones fractures often surgically fixed?
How are Jones fractures often surgically fixed?
Signup and view all the flashcards
What is another surgical technique used specifically for avulsion fractures?
What is another surgical technique used specifically for avulsion fractures?
Signup and view all the flashcards
What promising alternative exists for Jones fracture fixation?
What promising alternative exists for Jones fracture fixation?
Signup and view all the flashcards
What is a major complication risk of Jones fractures?
What is a major complication risk of Jones fractures?
Signup and view all the flashcards
How are non-displaced fifth metatarsal fractures often treated?
How are non-displaced fifth metatarsal fractures often treated?
Signup and view all the flashcards
When is surgery typically needed for fifth metatarsal fractures?
When is surgery typically needed for fifth metatarsal fractures?
Signup and view all the flashcards
What are some potential complications associated with fifth metatarsal fractures?
What are some potential complications associated with fifth metatarsal fractures?
Signup and view all the flashcards
Acceptable Metatarsal Fracture Angulation and Translation
Acceptable Metatarsal Fracture Angulation and Translation
Signup and view all the flashcards
Sagittal Plane Displacement in Metatarsal Fractures
Sagittal Plane Displacement in Metatarsal Fractures
Signup and view all the flashcards
Dorsal Angulation in Metatarsal Fractures
Dorsal Angulation in Metatarsal Fractures
Signup and view all the flashcards
Transverse Plane Displacement in Metatarsal Fractures
Transverse Plane Displacement in Metatarsal Fractures
Signup and view all the flashcards
Metatarsal Head Abutment
Metatarsal Head Abutment
Signup and view all the flashcards
Frontal Plane Displacement in Metatarsal Fractures
Frontal Plane Displacement in Metatarsal Fractures
Signup and view all the flashcards
Functional Forefoot Requirements
Functional Forefoot Requirements
Signup and view all the flashcards
Treating Central Metatarsal Fractures
Treating Central Metatarsal Fractures
Signup and view all the flashcards
Central Metatarsal Displacement
Central Metatarsal Displacement
Signup and view all the flashcards
Causes of Central Metatarsal Fractures
Causes of Central Metatarsal Fractures
Signup and view all the flashcards
Most Common Central Metatarsal Fracture Complication
Most Common Central Metatarsal Fracture Complication
Signup and view all the flashcards
Stability of Central Metatarsal Fractures
Stability of Central Metatarsal Fractures
Signup and view all the flashcards
Fifth Metatarsal Fracture Prevalence
Fifth Metatarsal Fracture Prevalence
Signup and view all the flashcards
First Metatarsal's Independent Motion
First Metatarsal's Independent Motion
Signup and view all the flashcards
Avulsion Fracture
Avulsion Fracture
Signup and view all the flashcards
Central Metatarsal Blood Supply
Central Metatarsal Blood Supply
Signup and view all the flashcards
Jones Fracture
Jones Fracture
Signup and view all the flashcards
Intramedullary Screw Fixation
Intramedullary Screw Fixation
Signup and view all the flashcards
Medullary Curettage and Bone Grafting
Medullary Curettage and Bone Grafting
Signup and view all the flashcards
Sural Nerve Irritation
Sural Nerve Irritation
Signup and view all the flashcards
Medullary Canal
Medullary Canal
Signup and view all the flashcards
Tension Band Wiring
Tension Band Wiring
Signup and view all the flashcards
Charlotte Carolina Jones Fracture System
Charlotte Carolina Jones Fracture System
Signup and view all the flashcards
Inadequate Blood Supply in Jones Fractures
Inadequate Blood Supply in Jones Fractures
Signup and view all the flashcards
Nonunion
Nonunion
Signup and view all the flashcards
Delayed union
Delayed union
Signup and view all the flashcards
Acceptable fracture angulation
Acceptable fracture angulation
Signup and view all the flashcards
Acceptable fracture translation
Acceptable fracture translation
Signup and view all the flashcards
What is the most common metatarsal to fracture?
What is the most common metatarsal to fracture?
Signup and view all the flashcards
What is an avulsion fracture?
What is an avulsion fracture?
Signup and view all the flashcards
What is a Jones fracture?
What is a Jones fracture?
Signup and view all the flashcards
What makes up a functional forefoot?
What makes up a functional forefoot?
Signup and view all the flashcards
Why are central metatarsal fractures relatively stable?
Why are central metatarsal fractures relatively stable?
Signup and view all the flashcards
How does the blood supply reach the central metatarsals?
How does the blood supply reach the central metatarsals?
Signup and view all the flashcards
Avulsion Fracture of the Fifth Metatarsal
Avulsion Fracture of the Fifth Metatarsal
Signup and view all the flashcards
Non-operative treatment for Fifth Metatarsal Fractures
Non-operative treatment for Fifth Metatarsal Fractures
Signup and view all the flashcards
Nonunion of Fifth Metatarsal Fracture
Nonunion of Fifth Metatarsal Fracture
Signup and view all the flashcards
Complications of Surgical Treatments for Fifth Metatarsal Fractures
Complications of Surgical Treatments for Fifth Metatarsal Fractures
Signup and view all the flashcards
Fifth Metatarsal Avulsion Fracture
Fifth Metatarsal Avulsion Fracture
Signup and view all the flashcards
Nonunion of Jones Fracture
Nonunion of Jones Fracture
Signup and view all the flashcards
Metatarsalgia
Metatarsalgia
Signup and view all the flashcards
Functional forefoot
Functional forefoot
Signup and view all the flashcards
What is a nonunion?
What is a nonunion?
Signup and view all the flashcards
What is medullary curettage and bone grafting?
What is medullary curettage and bone grafting?
Signup and view all the flashcards
Most Common Metatarsal Fracture
Most Common Metatarsal Fracture
Signup and view all the flashcards
Why are nonunions uncommon with central metatarsal fractures?
Why are nonunions uncommon with central metatarsal fractures?
Signup and view all the flashcards
What types of forces can cause central metatarsal fractures?
What types of forces can cause central metatarsal fractures?
Signup and view all the flashcards
Why are Jones fractures difficult to treat?
Why are Jones fractures difficult to treat?
Signup and view all the flashcards
Medullary Curettage & Bone Grafting
Medullary Curettage & Bone Grafting
Signup and view all the flashcards
Fifth Metatarsal - Most Common Metatarsal Fracture
Fifth Metatarsal - Most Common Metatarsal Fracture
Signup and view all the flashcards
Jones Fracture Location
Jones Fracture Location
Signup and view all the flashcards
Fifth Metatarsal Fracture
Fifth Metatarsal Fracture
Signup and view all the flashcards
Multiple Metatarsal Fractures: Initial Treatment
Multiple Metatarsal Fractures: Initial Treatment
Signup and view all the flashcards
Percutaneous Pinning: Alternative Fixation
Percutaneous Pinning: Alternative Fixation
Signup and view all the flashcards
Multiple Metatarsal Fractures: Open Procedures
Multiple Metatarsal Fractures: Open Procedures
Signup and view all the flashcards
Minimally Invasive Repair: Procedure
Minimally Invasive Repair: Procedure
Signup and view all the flashcards
Central Metatarsal Fractures: Open Reduction
Central Metatarsal Fractures: Open Reduction
Signup and view all the flashcards
Minimally Invasive Repair: Advantage
Minimally Invasive Repair: Advantage
Signup and view all the flashcards
Open Reduction: Benefits
Open Reduction: Benefits
Signup and view all the flashcards
Central Metatarsal Displacement: Unit Movement
Central Metatarsal Displacement: Unit Movement
Signup and view all the flashcards
The first metatarsal
The first metatarsal
Signup and view all the flashcards
What is non-operative treatment for Fifth Metatarsal Fractures?
What is non-operative treatment for Fifth Metatarsal Fractures?
Signup and view all the flashcards
Why are Jones fractures tricky to treat?
Why are Jones fractures tricky to treat?
Signup and view all the flashcards
Which metatarsal bone is most commonly fractured?
Which metatarsal bone is most commonly fractured?
Signup and view all the flashcards
What is a nonunion in terms of bone fractures?
What is a nonunion in terms of bone fractures?
Signup and view all the flashcards
Why is the fifth metatarsal base a common fracture site?
Why is the fifth metatarsal base a common fracture site?
Signup and view all the flashcards
Fifth Metatarsal
Fifth Metatarsal
Signup and view all the flashcards
Most Common Complication of Central Metatarsal Fracture
Most Common Complication of Central Metatarsal Fracture
Signup and view all the flashcards
What is intramedullary screw fixation?
What is intramedullary screw fixation?
Signup and view all the flashcards
Fifth Metatarsal Fracture: The Most Common
Fifth Metatarsal Fracture: The Most Common
Signup and view all the flashcards
Central Metatarsal Fracture Stability
Central Metatarsal Fracture Stability
Signup and view all the flashcards
Metatarsalgia: Post-Fracture Foot Pain
Metatarsalgia: Post-Fracture Foot Pain
Signup and view all the flashcards
Medullary Curettage and Bone Grafting: Jones Fracture Treatment
Medullary Curettage and Bone Grafting: Jones Fracture Treatment
Signup and view all the flashcards
Why Jones Fractures are Difficult to Treat
Why Jones Fractures are Difficult to Treat
Signup and view all the flashcards
Nonunion: When a Fracture Doesn't Heal
Nonunion: When a Fracture Doesn't Heal
Signup and view all the flashcards
What is the most common type of metatarsal fracture?
What is the most common type of metatarsal fracture?
Signup and view all the flashcards
What is the most frequent complication after treatment of central metatarsal fractures?
What is the most frequent complication after treatment of central metatarsal fractures?
Signup and view all the flashcards
What is a delayed union?
What is a delayed union?
Signup and view all the flashcards
What is acceptable fracture angulation?
What is acceptable fracture angulation?
Signup and view all the flashcards
Multiple Metatarsal Fractures
Multiple Metatarsal Fractures
Signup and view all the flashcards
Study Notes
Metatarsal Fractures
- Metatarsal fractures are a common cause of forefoot pain, representing 35% of all foot fractures and 5% of total skeletal fractures.
- Fractures may be isolated, concurrent with other metatarsal fractures, or associated with Lisfranc injuries.
- Direct or indirect trauma can cause metatarsal fractures, though high-energy crush injuries are also possible. These injuries have a primary concern for the soft tissue envelope, requiring compartment syndrome evaluation before osseous intervention.
- Metatarsal fractures are categorized by location: proximal metaphyseal, diaphyseal (shaft), and head/neck.
- Proximal metaphyseal and base fractures often remain relatively stable due to supporting soft tissues and articulations.
- Diaphyseal fractures are usually oblique, needing evaluation for shortening, angulation, and displacement.
- Distal metaphyseal fractures are commonly transverse or oblique, often displacing plantarly and laterally.
- The first metatarsal is the thickest, strongest, shortest, and heaviest metatarsal. It's less frequently fractured in adults (1.5% incidence) but more frequently in children. Lower energy trauma is the usual cause.
- High-energy fractures require prioritizing soft tissue envelope health over immediate osseous treatment.
- Metatarsal fractures, especially those involving the fifth metatarsal, may be associated with fractures in other central metatarsals. Fractures are often contiguous.
- Careful radiographic assessment is important in case of isolated fractures, as contiguous fractures are common.
- Avulsion fractures can occur at the base of the first metatarsal due to plantar flexion and inversion injuries related to peroneus longus and tibialis anterior attachments.
- Intramedullary screw fixation, with considerations for size, avoiding penetration of the medial cortex, and appropriate screw placement, is sometimes used.
- The goal of treatment is to maintain a functional forefoot, considering the metatarsal parabola, the sagittal plane position of metatarsal heads, and bone to bone contact.
- Special consideration should be given to fractures involving the first metatarsal, central metatarsals, and the fifth metatarsal, as their unique anatomical and functional characteristics may necessitate different treatment approaches.
First Metatarsal
- First metatarsals are crucial for function and gait.
- A disruption in their integrity can lead to gait disturbances affecting the entire limb, including the medial column, first metatarsophalangeal joint and the lesser metatarsals.
- Pain may be presented in the first metatarsophalangeal joint or proximally along the medial column, or at the lesser metatarsals, or, in severe cases, the entire limb.
- Because of unique function and commonality with central metatarsals, first, central, and fifth metatarsals should be examined separately. This evaluation is important for potential gait disturbance and maintaining functional forefoot mobility.
- The first metatarsal has a large, kidney-shaped articular surface for the medial cuneiform.
- The head is completely covered by articular cartilage for its articulation with the proximal phalanx distally, and the sesamoids plantarly. Articulations are important for normal function.
- The first metatarsal is supplied by the dorsal, plantar, and medial plantar metatarsal arteries, commonly originating from the first dorsal artery.
- The first metatarsal's anatomy, including the size of the medullary canal, and patient activity should be factored into the selection of fixation options. The anatomy and function of the first metatarsal need to be considered when planning treatment.
- Displacement in the sagittal plane of the first metatarsal is less well tolerated than longitudinal plane displacement. This can impact the hallux and lead to gait problems.
- Metatarsalgia can occur if there is malalignment, nonunion, or malunion and affects the function of the forefoot, midfoot, and entire limb.
- Screw size, overdrilling of the bone, and proper screw placement should be considered in intramedullary screw fixation.
Central Metatarsals
- Multiple metatarsal fractures are common, often involving contiguous bones.
- Radiographic assessment is important when considering isolated metatarsal fractures due to the high likelihood of additional involvement.
- Central metatarsals are stabilized by plantar, dorsal, and interosseous ligaments, with the tibialis posterior being the only extrinsic attachment.
- The shafts of these metatarsals serve as origins for intrinsic plantar and dorsal interossei muscles.
- Injury is caused by indirect torsional or direct trauma such as a crushing blow to the dorsum of the foot, or twisting.
- The primary nutrient artery enters laterally, approximately 3.1 cm from the distal articular cartilage.
- In cases of multiple metatarsal fractures, the most severely displaced fracture is often prioritized for reduction and stabilization, potentially eliminating the need for additional interventions for adjacent fractures.
Fifth Metatarsal
- The fifth metatarsal accounts for a significant percentage of metatarsal fractures (up to 68%).
- Similar to the first, it functions independently of central metatarsals, relying on its own specific anatomical supports.
- It has a unique tuberosity for tendon attachment, specifically the peroneus brevis and tertius tendons. The lateral slip of the plantar fascia also inserts here.
- Fractures are classified into head/neck, shaft, and base.
- Base fractures are a concern due to potential avulsion fractures (intra- or extra-articular) that are often caused by inversion type injuries, or the pull of the lateral band of the plantar aponeurosis, which may necessitate tendon reattachment. These avulsion fractures are concerning due to the potential involvement with the plantar aponeurosis, requiring careful surgical planning and potential tendon realignment.
- The fifth metatarsal's vascularity is often inadequate, particularly in the proximal diaphysis, potentially leading to delayed healing. This is also a concern for Jones fractures.
- The distal fifth metatarsal, near the metatarsal/diaphyseal junction, is particularly prone to fractures (Jones fracture). This area of the bone has poorer blood supply, which can affect healing time.
Metatarsal Fracture Treatment
- Conservative treatment may be appropriate for nondisplaced or minimally displaced fractures in some cases, usually with immobilization and protected weight-bearing. Often with supportive footwear such as a fracture boot.
- Surgical intervention is often required for displaced or severely impacted fractures that affect overall functional outcomes, particularly those causing significant shortening or angular deformity.
- Consideration of soft tissue factors and the adequacy of stabilization is crucial. Displacement is less tolerated in the sagittal plane compared to the frontal plane.
- Treatment methods can include intramedullary screw fixation (with considerations for screw size, placement, and avoiding overdrilling bone), percutaneous pinning, open reduction, plate fixation, and additional soft tissue techniques. Considerations for appropriate surgical procedures should be based on the severity of the fracture, amount of displacement, and the degree of soft-tissue involvement. Techniques like tension band wiring and additional soft-tissue techniques may need to complement the primary fixation. Appropriate screw length, avoiding damage to associated structures, and appropriate screw placement are also critical considerations.
- In cases of nonunion or delayed healing, additional interventions like bone grafting may be considered.
- For cases involving significant soft tissue damage, stabilization should address soft tissue before addressing bony healing.
- Careful attention to the anatomical characteristics of each metatarsal type and fracture location is crucial for optimal treatment planning and outcomes.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.