Objective To explore the effectiveness and operative methods to treat first metatarsal diaphysis comminuted fractures with mini-plate via medial approach.
Methods Between January 2012 and January 2013, 15 patients with first metatarsal shaft comminuted fractures were treated. There were 11 males and 4 females (6 left feet and 9 right feet) with an average age of 38.6 years (range, 27-56 years). The injury causes included falling injury in 6 cases, crash injury of heavy object in 7 cases, and sprain in 2 cases. The left side was involved in 6 cases and the right side in 9 cases. The time from injury to operation was 8.5 days on average (range, 7-10 days). According to AO classification, all cases were rated as 81(T)-C2 type. The surgical treatments included open reduction and internal fixation with mini-plate by medial approach.
Results Primary healing of incision was obtained in all cases, and no infection occurred. Twelve patients were followed up 18 months on average (range, 12-24 months). All fractures healed well, and the mean time of bone union was 11.5 weeks (range, 10-14 weeks). No loosening or breakage of internal fixation was observed. At last follow-up, the patients could walk with full weight-bearing, and had no pain. According to American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal scale, the mean score was 85.2 (range, 76-96).
Conclusion Anatomic reduction and stable internal fixation are important for first metatarsal comminuted fracture, which is the key point for recovery of foot form and foot arch function. And the medial approach could achieve full exposure and improve the cosmetic results.
Citation：
LIBing, YANGYunfeng, CHENKai, YUTao, RENHaoyang, CHENDawei, YUGuangrong. TREATMENT OF FIRST METATARSAL DIAPHYSIS COMMINUTED FRACTURES WITH MINI-PLATE VIA MEDIAL APPROACH. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(2): 138-140. doi: 10.7507/1002-1892.20150029
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Copyright © the editorial department of Chinese Journal of Reparative and Reconstructive Surgery of West China Medical Publisher. All rights reserved
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- 1. Hatch RL, Alsobrook JA, Clugston JR. Diagnosis and management of metatarsal fractures. Am Fam Physician, 2007, 76(6):817-826.
- 2. Lee DK, Mulder GD, Schwartz AK. Hallux, sesamoid, and first metatarsal injuries. Clin Podiatr Med Surg, 2011, 28(1):43-56.
- 3. 俞光荣, 李兵, 杨云峰, 等. 第一跖骨骨折的手术治疗. 中华创伤杂志, 2009, 25(1):44-47.
- 4. Niki H, Aoki H, Inokuchi S, et al. Development and reliability of a standard rating system for outcome measurement of foot and ankle disorders I:development of standard rating system. J Orthop Sci, 2005, 10(5):457-465.
- 5. Armagan OE, Shereff MJ. Injury to the toes and metatarsal. Orthop Clin North Am, 2001, 32(1):1-10.
- 6. Rammelt S, Heineck J, Zwipp H. Metatarsal fractures. Injury, 2004, 35 Suppl 2:SB77-86.
- 7. Cakir H, Van Vliet-Koppert ST, Van Lieshout EM, et al. Demographics and outcome of metatarsal fractures. Arch Orthop Trauma Surg, 2011, 131(2):241-245.
- 8. Buddecke DE, Polk MA, Barp EA. Metatarsal fractures. Clin Podiatr Med Surg, 2010, 27(4):601-624.
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