J Korean Foot Ankle Soc.  2014 Mar;18(1):24-28. 10.14193/jkfas.2014.18.1.24.

Surgical Treatment of the Fifth Metatarsal Base Fracture Using Multiple Kirschner Wires

• Kim J
• Kim JW
• Lee JI
• Kim SK
• Rhee SH

• KMID: 1958735
• DOI: http://doi.org/10.14193/jkfas.2014.18.1.24

Abstract

PURPOSE
The purpose of this study is to evaluate the clinical and radiographic results of internal fixation using multiple Kirschner wires (K-wires) for the fifth metatarsal base fracture.
MATERIALS AND METHODS
We retrospectively reviewed 14 patients with a displaced fifth metatarsal base fracture. We measured the distance of fracture displacement on the foot oblique radiograph pre- and post-operatively. We evaluated the clinical results using the visual analog pain scale at six weeks and three months postoperatively and the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score at six months postoperatively.
RESULTS
In our series, 10 cases were zone I fracture and four cases were zone II fracture. We achieved anatomical reduction and bony union in all of our cases. The average time to bone union was 43 days. The degree of pain around the fifth metatarsal base was significantly decreased after surgery. The average AOFAS score was 95 at six months postoperatively.
CONCLUSION
Multiple K-wire fixation is a relatively simple fixation method for displaced fifth metatarsal base fractures. If we place a K-wire into the medial cortex of the fifth metatarsal, we could prevent proximal migration of the K-wire.

Keyword

Proximal fifth metatarsal fracture; Kirschner wires

MeSH Terms

Ankle
Bone Wires*
Foot
Humans
Metatarsal Bones*
Pain Measurement
Retrospective Studies

Figure

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  Figure 1. (A) A 34-year-old woman with displaced intraarticular avulsion fracture of the fifth metatarsal. (B) Immediate postoperative foot anteroposterior image after open reduction and internal fixation with 3 Kirschner wires. (C) Immediate postoperative foot oblique image showing anatomically reduced fifth metatarsal base fracture. (D) Final foot oblique image after implant removal 7 months postoperatively.

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  Figure 2. The average visual analogue pain scale was significantly decreased after surgery (p<0.001). Preop: preoperative, Postop: postoperative.

Reference

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