Abstract :
[en] The authors report their experience with operative treatment of 18 proximal fifth metatarsal stress fracture in 17 soccer players.
Percutaneous intramedullary fixation with a 4.5 mm malleolar screw was used in 11 patients (group 1) and open intramedullary screw fixation associated with autologous cancellous bone grafting in 7 other (group 2). The average follow-up was 3.1 years.
Clinical and radiographic union was obtained in all cases. The average return to full sports practice was 12 weeks. Refracture occurred in three players in the first group at 4.5, 5.2 and 6.0 months after return to full sport activity. They underwent reoperation with screw exchange, curettage of the fracture site and autologous cancellous bone grafting. No case of refracture was reported in the second group.
On the basis of this series, intramedullary screw fixation associated with autologous cancellous bone grafting seems to be a reasonable primary treatment in high level soccer players.
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