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New Classification for Pediatric Proximal Fifth Metatarsal Fractures.
Lee, Hannah A; Batley, Morgan G; Krakow, Arielle; Buczek, Matthew J; Sarkar, Sulagna; Talwar, Divya; Horn, Bernard David; Davidson, Richard S.
Afiliação
  • Lee HA; Department of Orthopaedics, The Children's Hospital of Philadelphia, PA.
  • Batley MG; Department of Orthopaedics, The Children's Hospital of Philadelphia, PA.
  • Krakow A; Department of Orthopaedics, The Children's Hospital of Philadelphia, PA.
  • Buczek MJ; Department of Orthopaedics, The Children's Hospital of Philadelphia, PA.
  • Sarkar S; Department of Orthopaedics, The Children's Hospital of Philadelphia, PA.
  • Talwar D; Department of Orthopaedics, The Children's Hospital of Philadelphia, PA.
  • Horn BD; Department of Orthopaedics, The Children's Hospital of Philadelphia, PA.
  • Davidson RS; Department of Orthopaedics, The Children's Hospital of Philadelphia, PA. Electronic address: davidsonr@chop.edu.
J Foot Ankle Surg ; 63(2): 267-274, 2024.
Article em En | MEDLINE | ID: mdl-38052380
Proximal fifth metatarsal fractures are the most common foot fractures in children. Attempts to classify these injuries are misapplied and inadequately predict outcomes. This is the first study to identify factors associated with healing in pediatric fifth metatarsal fractures. In this retrospective cohort study (N = 305), proximal fifth metatarsal fractures were classified on radiographs by location on the bone, alignment (transverse or oblique), displacement (>2 mm), and completion through the bone. Based on the literature, they were secondarily sorted by category: apophyseal, intra-articular metaphyseal, extra-articular metaphyseal, and diaphyseal. Primary outcomes included times to healing, indicated by clinical symptoms, immobilization, and return to sports, as well as radiographic callus formation, bridging, and remodeling. Healing times were compared by ANOVA and linear regression. Location had a significant effect on times of immobilization and return to sports, but alignment, displacement, and completion were not associated with healing. When re-classified, the categories were also associated with immobilization and return to sports. Apophyseal fractures healed fastest and diaphyseal fractures required the most time to heal. There was no difference between extra- and intra-articular fractures. For every year of age, symptoms resolved about 2 days sooner. Neither gender nor body mass index (BMI) was positively or negatively associated with healing times. In conclusion, classifying fractures by apophyseal, metaphyseal, and diaphyseal is the most concise, accurate, and useful system. This is the largest series of nonoperatively treated proximal fifth metatarsal fractures in children and a robust standard to which surgical management can be compared.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ossos do Metatarso / Traumatismos do Pé / Fraturas Ósseas Limite: Child / Humans / Newborn Idioma: En Revista: J Foot Ankle Surg Ano de publicação: 2024 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ossos do Metatarso / Traumatismos do Pé / Fraturas Ósseas Limite: Child / Humans / Newborn Idioma: En Revista: J Foot Ankle Surg Ano de publicação: 2024 Tipo de documento: Article País de publicação: Estados Unidos