Fractures of Base of Fifth Metatarsal

Abstract

An investigation into the best method of treatment of fractures of the styloid process of the fifth metatarsal has been made in 146 patients who attended the General Hospital, Birmingham, between September, 1958, and September, 1960. The patients were divided into four groups according to whether they were treated by immobilization in plaster-of-Paris or immediate mobilization and associated infiltration of the fracture site with procaine or hydrocortisone, or mobilization with the help of a supportive bandage. The groups were further analysed in regard to occupation. In assessing the results of treatment, attention was paid to relief of pain, duration of time off work, and residual disability. A limited radiological survey showed non-union in three patients in each of the procaine and hydrocortisone series, but none had any disability. Of the 65 patients treated with plaster-of-Paris, 66% were off work for over a week, the average being three to four weeks ; 40% were off work for four weeks or more. Fourteen patients had residual stiffness. Twenty-six patients were treated by injection of procaine into the site of the fracture. With the exception of two failures, no patient lost more than two days from work. there was no residual disability All 27 patients treated by injection of hydrocortisone into the fracture site were free from pain in one week. No patient was off work for longer than a week. There was no residual disability Of the 28 patients treated by support in the form of a below-knee crêpe bandage, 42.8% were off work for one week or more, the average time off work for the whole series being 8 days. Three patients had residual aching pain. © 1962, British Medical Journal Publishing Group. All rights reserved.