Description
This presentation by Timothy Clough provides an in-depth analysis of fifth metatarsal fractures, with a particular focus on the Jones fracture. Clough begins by outlining the types of fifth metatarsal fractures classified by Lawrence and Botte, differentiating between avulsion fractures, Jones fractures, and dancers' fractures. He emphasizes that while most avulsion fractures typically heal well with conservative management, Jones fractures require more attention due to their higher incidence of nonunion, especially in athletic populations.
Clough points out that in football, foot and ankle injuries constitute about 20% of all injuries, with fifth metatarsal fractures accounting for approximately 13% of these. He presents statistics showing that a professional football team may expect a fifth met fracture approximately every 63 games. After discussing the common mechanisms of injury, he transitions into treatment options, advocating for surgical intervention in elite athletes to prevent complications associated with nonunion.
The presentation includes review findings from various studies supporting the effectiveness of surgical fixation with intramedullary screws resulting in lower nonunion rates compared to conservative management. Clough discusses considerations such as screw diameter, length, and placement to optimize surgical outcomes while also exploring options for managing nonunions, including the use of biological additives like bone grafts. He stresses the importance of careful monitoring and imaging to guide return-to-play decisions and highlights that healing time varies significantly among athletes based on individual factors.
Concluding the presentation, Clough reflects on the implications for practitioners in sports medicine, noting the critical balance between conservative versus surgical management based on patient needs and the significance of thorough follow-up.