5th Metatarsal Jones Fracture - To Treat Conservatively, or
Surgically Using Headless Double-Threaded Herbert Screw?

J 2023

5th Metatarsal Jones Fracture - To Treat Conservatively, or Surgically Using Headless Double-Threaded Herbert Screw?

DEMEL, Jiří; Ladislav PLÁNKA; R. STICHHAUER; A. VRTKOVÁ; G. BAJOR et. al.

Základní údaje

Originální název

5th Metatarsal Jones Fracture - To Treat Conservatively, or Surgically Using Headless Double-Threaded Herbert Screw?

Název česky

Jonesova zlomenina 5. metatarzu - léčit konzervativně nebo chirurgicky bezhlavičkovým dvouzávitovým Herbertovým šroubem?

Autoři

DEMEL, Jiří; Ladislav PLÁNKA; R. STICHHAUER; A. VRTKOVÁ; G. BAJOR; M. HAVLÍČEK a L. PLEVA

Vydání

ACTA CHIRURGIAE ORTHOPAEDICAE ET TRAUMATOLOGIAE CECHOSLOVACA, PRAGUE, GALEN SRO, 2023, 0001-5415

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30212 Surgery

Stát vydavatele

Česká republika

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 0.400

Kód RIV

RIV/00216224:14110/23:00131643

Organizační jednotka

Lékařská fakulta

UT WoS

000995061900008

EID Scopus

2-s2.0-85150225693

Klíčová slova anglicky

Jones fracture; AOFAS; Herbert screw; 5th metatarsal fracture; surgical treatment

Štítky

14110313, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 19. 2. 2024 12:50, Mgr. Tereza Miškechová

Anotace

V originále

PURPOSE OF THE STUDY Fifth metatarsal fractures, in particular so-called Jones fractures, are relatively common injuries both in the general population and athletes. Although discussions about whether the surgical or conservative solution should be preferred are ongoing for decades, there is no clear consensus. Here, we aimed to prospectively compare the results of osteosynthesis using the Herbert screw with the conservative solution in patients from our department. MATERIAL AND METHODS Patients 18-50 years presenting to our department with Jones fracture and meeting further inclusion/exclusion criteria were offered participation in the study. Those willing to participate signed informed consent and were randomized by flipping the coin into surgically and conservatively treated groups. After six and twelve weeks, X-ray was performed in each patient and AOFAS score was determined. Conservatively treated patients who showed no signs of healing and whose AOFAS was below 80 after six weeks were offered surgery again. RESULTS Of 24 patients in total, 15 were assigned to the surgically treated group and nine were treated conservatively. After six weeks, AOFAS score of all but two patients (86%) in the surgically treated group ranged between 97 and 100, while this score exceeded 90 points only in three patients (33%) from the conservatively treated group. On X-ray, successful healing after six weeks was observed in seven patients (47%) from the surgically treated group but in none of the patients from the conservatively treated group. Three out of five patients in the conservative group whose AOFAS was below 80 after six weeks opted for surgery at that time and all improved significantly by the twelfth week. DISCUSSION Although studies on surgical treatment of Jones fracture using various screws or plates are not rare, we present an uncommon method of surgical treatment of this injury - the use of the Herbert screw. The results of this method are excellent and even on a relatively small sample yielded statistically significantly better results than conservative treatment. Moreover, the surgical treatment facilitated early loading of the injured limb, which allows an earlier return of the patients to normal life. CONCLUSIONS Osteosynthesis using Herbert screw in Jones fracture yielded significantly better results than conservative treatment.

Citovat

DEMEL, Jiří; Ladislav PLÁNKA; R. STICHHAUER; A. VRTKOVÁ; G. BAJOR; M. HAVLÍČEK a L. PLEVA. 5th Metatarsal Jones Fracture - To Treat Conservatively, or Surgically Using Headless Double-Threaded Herbert Screw? ACTA CHIRURGIAE ORTHOPAEDICAE ET TRAUMATOLOGIAE CECHOSLOVACA. PRAGUE: GALEN SRO, 2023, roč. 90, č. 1, s. 53-58. ISSN 0001-5415.

@article{2308677,
   author = {Demel, Jiří and Plánka, Ladislav and Stichhauer, R. and Vrtková, A. and Bajor, G. and Havlíček, M. and Pleva, L.},
   article_location = {PRAGUE},
   article_number = {1},
   keywords = {Jones fracture; AOFAS; Herbert screw; 5th metatarsal fracture; surgical treatment},
   language = {eng},
   issn = {0001-5415},
   journal = {ACTA CHIRURGIAE ORTHOPAEDICAE ET TRAUMATOLOGIAE CECHOSLOVACA},
   title = {5th Metatarsal Jones Fracture - To Treat Conservatively, or Surgically Using Headless Double-Threaded Herbert Screw?},
   url = {https://achot.actavia.cz/pdfs/ach/2023/01/08.pdf},
   volume = {90},
   year = {2023}
}

TY  - JOUR
ID  - 2308677
AU  - Demel, Jiří - Plánka, Ladislav - Stichhauer, R. - Vrtková, A. - Bajor, G. - Havlíček, M. - Pleva, L.
PY  - 2023
TI  - 5th Metatarsal Jones Fracture - To Treat Conservatively, or Surgically Using Headless Double-Threaded Herbert Screw?
JF  - ACTA CHIRURGIAE ORTHOPAEDICAE ET TRAUMATOLOGIAE CECHOSLOVACA
VL  - 90
IS  - 1
SP  - 53-58
EP  - 53-58
PB  - GALEN SRO
SN  - 00015415
KW  - Jones fracture
KW  - AOFAS
KW  - Herbert screw
KW  - 5th metatarsal fracture
KW  - surgical treatment
UR  - https://achot.actavia.cz/pdfs/ach/2023/01/08.pdf
N2  - PURPOSE OF THE STUDY Fifth metatarsal fractures, in particular so-called Jones fractures, are relatively common injuries both in the general population and athletes. Although discussions about whether the surgical or conservative solution should be preferred are ongoing for decades, there is no clear consensus. Here, we aimed to prospectively compare the results of osteosynthesis using the Herbert screw with the conservative solution in patients from our department. MATERIAL AND METHODS Patients 18-50 years presenting to our department with Jones fracture and meeting further inclusion/exclusion criteria were offered participation in the study. Those willing to participate signed informed consent and were randomized by flipping the coin into surgically and conservatively treated groups. After six and twelve weeks, X-ray was performed in each patient and AOFAS score was determined. Conservatively treated patients who showed no signs of healing and whose AOFAS was below 80 after six weeks were offered surgery again. RESULTS Of 24 patients in total, 15 were assigned to the surgically treated group and nine were treated conservatively. After six weeks, AOFAS score of all but two patients (86%) in the surgically treated group ranged between 97 and 100, while this score exceeded 90 points only in three patients (33%) from the conservatively treated group. On X-ray, successful healing after six weeks was observed in seven patients (47%) from the surgically treated group but in none of the patients from the conservatively treated group. Three out of five patients in the conservative group whose AOFAS was below 80 after six weeks opted for surgery at that time and all improved significantly by the twelfth week. DISCUSSION Although studies on surgical treatment of Jones fracture using various screws or plates are not rare, we present an uncommon method of surgical treatment of this injury - the use of the Herbert screw. The results of this method are excellent and even on a relatively small sample yielded statistically significantly better results than conservative treatment. Moreover, the surgical treatment facilitated early loading of the injured limb, which allows an earlier return of the patients to normal life. CONCLUSIONS Osteosynthesis using Herbert screw in Jones fracture yielded significantly better results than conservative treatment.
ER  -

DEMEL, Jiří; Ladislav PLÁNKA; R. STICHHAUER; A. VRTKOVÁ; G. BAJOR; M. HAVLÍČEK a L. PLEVA. 5th Metatarsal Jones Fracture - To Treat Conservatively, or Surgically Using Headless Double-Threaded Herbert Screw? \textit{ACTA CHIRURGIAE ORTHOPAEDICAE ET TRAUMATOLOGIAE CECHOSLOVACA}. PRAGUE: GALEN SRO, 2023, roč.~90, č.~1, s.~53-58. ISSN~0001-5415.

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