Orthopaedic Surgery Working Group, Society of Junior Doctors, Athens, Greece
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University of Patras, School of Medicine, Patras, Greece
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NIHR Leeds Biomedical Research Center, Chapel Allerton Hospital, Leeds, UK
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Even though fifth metatarsal fractures represent one of the most common injuries of the lower limb, there is no consensus regarding their classification and treatment, while the term ‘Jones’ fracture has been used inconsistently in the literature.
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In the vast majority of patients, Zone 1 fractures are treated non-operatively with good outcomes.
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Treatment of Zone 2 and 3 fractures remains controversial and should be individualized according to the patient’s needs and the ‘personality’ of the fracture.
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If treated operatively, anatomic reduction and intramedullary fixation with a single screw, with or without biologic augmentation, remains the ‘gold standard’ of management; recent reports however report good outcomes with open reduction and internal fixation with specifically designed plating systems.
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Common surgical complications include hardware failure or irritation of the soft tissues, refracture, non-union, sural nerve injury, and chronic pain.
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Patients should be informed of the different treatment options and be part of the decision process, especially where time for recovery and returning to previous activities is of essence, such as in the case of high-performance, elite athletes.
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syndesmosis may lead to significant disability and time loss. Early recognition and appropriate treatment are the keys to restore stability, mobility and strength, with the aim of regaining the pre-injury function of the ankle. Otherwise chronic pain
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dehiscence; however, there is a higher risk of radiological malunion ( 4 ). The incidence of chronic pain 1 year following non-operative treatment can be as high as 79% ( 5 ). Despite a study by Makwana et al. reporting an anatomical fixation rate of 86% in
Osteoarticular Surgery Research, Hospital La Paz Institute for Health Research – IdiPAZ (La Paz University Hospital – Autonomous University of Madrid), Madrid, Spain
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One case of type I CRPS was identified by Ferkel et al. after AA ( 5 ). CRPS is a chronic pain syndrome that is often instigated by postoperative or post-traumatic events ( 39 ). In 2011, Shah and Kirschner stated that CRPS is a challenging pain
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problem, which includes haematoma formation, infection, chronic pain, neurological deficits, iatrogenic fractures, and issues with cosmesis. 5 - 9 Furthermore, the amount of donor site bone graft available for harvesting is limited, which is a
