Functional treatment of acute metatarsal fractures: a prospective randomised comparison of management in a cast versus elasticated support bandage

      Summary

      A randomised controlled trial was performed in 50 patients with acute isolated minimally displaced lesser metatarsal fractures in order to compare plaster immobilisation with elasticated support bandage treatment. Patients treated with elasticated support bandage had significantly higher AOFAS mid-foot scores at 3-months follow-up and complained of less pain throughout the treatment period. There was no difference between the two groups in time to independent mobility, mid-foot circumference, analgesic requirements and radiological union at 3 months. As plaster casts are associated with serious complications, which were encountered in these studies, we conclude that minimally displaced metatarsal fractures are better treated without a cast.

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      References

        • Dameron T.B.
        Fractures of the proximal fifth metatarsal: selecting the best treatment option.
        J Am Acad Orthop Surg. 1995; 3: 110-114
        • Delee J.C.
        • Evans J.P.
        • Julian J.
        Stress fractures of the fifth metatarsal.
        Am J Sports Med. 1983; 11: 349-353
        • Egol K.A.
        • Dolan R.
        • Koval K.J.
        Functional outcome of surgery for fractures of the ankle. A prospective randomised comparison of management in a cast or a functional brace.
        J Bone Joint Surg Br. 2000; 82: 246-249
        • Eiff M.P.
        • Smith A.T.
        • Smith G.E.
        Early mobilisation versus immobilisation in the treatment of lateral ankle sprains.
        Am J Sports Med. 1994; 22: 83-88
        • Gosele A.
        • Schulenburg J.
        • Oschner P.E.
        Early functional treatment of a fifth metatarsal fracture using an orthopaedic boot.
        Swiss Surg. 1997; 3: 81-84
        • Johnson V.S.
        Treatment of Fractures of the Forefoot in Industry.
        in: Bateman J.E. Foot Science. Saunders, Philadelphia W.B.1976 (pp. 257–265)
      1. Rockwood and Green's Fractures in Adults. vol. 2. Lippincott–Raven, Philadelphia1996 (p. 2374)
        • Kitaoka H.B.
        • Alexander I.J.
        • Adelaar R.S.
        • et al.
        Clinical rating systems for the ankle—hindfoot, midfoot, hallux and lesser toes.
        Foot Ankle Int. 1994; 15: 349-353
        • Nunley J.A.
        Fractures of the base of the fifth metatarsal: the Jones fracture.
        Orthop Clin North Am. 2001; 32: 171-180
        • Port A.M.
        • McVie J.L.
        • Naylor G.
        • Kreibich D.N.
        Comparison of two conservative methods of treating an isolated fracture of the lateral malleolus.
        J Bone Joint Surg Br. 1996; 78: 568-572
        • Richter J.
        • Langer C.
        • Hahn M.P.
        • et al.
        Is functional conservative treatment of stable lateral ankle fractures justified?.
        Chirurg. 1996; 67: 1255-1260
        • Spector F.
        • Karlin J.
        • Scurran B.L.
        Lesser metatarsal fractures: incidence, management and review.
        J Am Podiatry Assoc. 1984; 74: 259-264
        • Tropp H.
        • Norlin R.
        Ankle performance after ankle fracture: a randomised study of early mobilisation.
        Foot Ankle Int. 1995; 16: 79-83
        • Wiener B.D.
        • Linder J.F.
        • Giattini J.F.
        Treatment of fractures of a fifth metatarsal: a prospective study.
        Foot Ankle Int. 1997; 18: 267-269