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Inicio Revista Española de Cirugía Ortopédica y Traumatología (English Edition) Initial support with no immobilisation as therapy of choice for fractures of the...
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Vol. 62. Issue 5.
Pages 348-358 (September - October 2018)
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Vol. 62. Issue 5.
Pages 348-358 (September - October 2018)
Original Article
DOI: 10.1016/j.recote.2018.07.004
Initial support with no immobilisation as therapy of choice for fractures of the fifth metatarsal
El apoyo inicial sin inmovilización como terapia de elección en las fracturas del quinto metatarsiano
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I. Úbeda-Pérez de Heredia
Servicio de Traumatología y Medicina Deportiva, Clínicas BEIMAN, Sevilla, Spain
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Tables (6)
Table 1. Overall sample composition. Fractures of the fifth metatarsal (n=382): number of cases and percentage of fractures according to the segment affected, therapeutic indication and treatment given.
Table 2. Means difference test. Length of temporary disability according to the type of treatment for fifth metatarsal fractures with conservative treatment indication (n=303).
Table 3. Means difference test. Length of temporary disability according to the type of treatment of fifth metatarsal fractures with surgical treatment indication (n=79).
Table 4. Means difference test. Influence of age and type of work on temporary disability in fifth metatarsal fractures with conservative treatment indication.
Table 5. Means difference test. Influence of age and type of job on temporary disability in fifth metatarsal fractures with surgical treatment indication.
Table 6. Complications of isolated fractures of the fifth metatarsal.
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Abstract
Aim

To demonstrate the effectiveness of early weight bearing with no immobilisation (functional therapy) applied to fractures of the fifth metatarsal.

Materials and method

A retrospective case and control observational study was performed among 382 fractures on the fifth metatarsal comparing functional, conservative-orthopaedic and surgical treatments. Fractures were classified according to the settlement on the distal, diaphyseal or proximal part of the bone, the recommended therapy and the treatment performed. Influence of age, profession and characteristics of the injury were considered and results were measured using the parameters incapacity for work and number and intensity of complications.

Discussion

Fractures of the fifth metatarsal are the most common injuries of the foot. Whether conservative or surgical treatment is recommended depends on the sort of fracture, the trend nowadays is to use non-invasive methods.

Conclusions

Functional treatment for metatarsal fractures provides earlier healing and fewer adverse effects than conventional therapies, and becomes first choice for non-displaced fractures and most displaced fractures of the fifth metatarsal.

Keywords:
Fifth metatarsal
Forefoot
Fracture
Weight bearing
Conservative treatment
Functional treatment
Resumen
Objetivo

Comprobar la efectividad del tratamiento de las fracturas del quinto metatarsiano mediante la aplicación de la carga precoz del miembro afecto sin inmovilización (tratamiento funcional).

Material y método

Estudio analítico observacional retrospectivo de casos y controles realizado sobre 382 fracturas del quinto metatarsiano en el que se compararon los resultados del tratamiento funcional con los tratamientos ortopédico y quirúrgico. Las fracturas se clasificaron en base a su localización distal, diafisaria o proximal, a la recomendación terapéutica y al tratamiento finalmente efectuado, y se estudió la influencia de las variables edad, actividad profesional y característica de cada fractura, evaluándose los resultados mediante la duración de la incapacidad temporal y el número y la gravedad de las complicaciones.

Discusión

Las fracturas del quinto metatarsiano son las lesiones más frecuentes del pie. El tratamiento puede ser conservador o quirúrgico dependiendo de cada tipo de fractura, existiendo en la actualidad una tendencia a utilizar métodos no invasivos.

Conclusiones

El método funcional proporciona una curación más temprana, así como menos complicaciones y de menor gravedad que los tratamientos clásicos, siendo de primera elección en las fracturas sin desplazamiento de los fragmentos y en prácticamente todas las fracturas desplazadas del quinto metatarsiano.

Palabras clave:
Quinto metatarsiano
Antepié
Fractura
Apoyo
Tratamiento conservador
Tratamiento funcional

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