[Functional outcome of 111 metatarsal fractures following conservative in comparison to operative treatment].

4区 医学 Q2 Medicine
Unfallchirurg Pub Date : 2022-04-01 Epub Date: 2021-05-22 DOI:10.1007/s00113-021-01006-6
Patrick Pflüger, Michael Zyskowski, Christopher Völk, Chlodwig Kirchhoff, Peter Biberthaler, Moritz Crönlein
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引用次数: 0

Abstract

Background: Fractures of the metatarsal bones are common injuries of the foot and particularly occur in patients aged 40-50 years. Especially multiple metatarsal fractures can lead to permanent limitations. Therefore, the aim of this study was to investigate the functional outcome of metatarsal fractures after conservative and surgical treatment using a validated self-reported patient-based outcome questionnaire.

Material and methods: All patients suffering from metatarsal fractures between 2003 and 2015 were enrolled in this retrospective analysis. The following data were collected: demographic data, AO classification, treatment, reoperation rate and the foot and ankle outcome score (FAOS). For outcome analysis, the nonparametric Mann-Whitney U‑test and Fisher's exact test were performed.

Results: In total the functional outcome of 111 patients with metatarsal fractures were analyzed, 81 patients suffered of an isolated metatarsal fracture and 30 of multiple fractures. The mean age of the patients was 45 ± 15.2 years with a total of 48 men (43%) and 63 women (57%). Patients with an isolated metatarsal fracture had an FAOS of 88 ± 17.1, while patients with multiple metatarsal fractures achieved an FAOS of 78 ± 17.7 (p = 0.046). In the group of isolated metatarsal fractures 43 patients (53%) were surgically treated and of these 36 patients showed a type C fracture (84%). In the group of multiple metatarsal fractures 16 patients (53%) underwent operative treatment.

Conclusion: Overall, the functional outcome of isolated metatarsal fractures following operative as well as conservative treatment is good to very good. Simple fractures can be successfully treated conservatively and complex multifragment fractures can be safely managed surgically. If more than one metatarsal bone is fractured, the functional outcome is significantly worse with patients reporting lasting limitations involving the range of motion and stiffness.

Abstract Image

Abstract Image

[111例跖骨骨折保守治疗与手术治疗的功能结果对比]。
背景:跖骨骨折是足部常见的损伤,尤其多发于 40-50 岁的患者。尤其是多发性跖骨骨折可导致永久性的功能受限。因此,本研究旨在使用经过验证的基于患者自我报告的疗效问卷,调查跖骨骨折在保守治疗和手术治疗后的功能疗效:2003年至2015年期间所有跖骨骨折患者均被纳入此次回顾性分析。收集的数据包括:人口统计学数据、AO分类、治疗方法、再手术率以及足踝结果评分(FAOS)。结果分析采用非参数曼-惠特尼U检验和费雪精确检验:结果:共对111名跖骨骨折患者的功能结果进行了分析,其中81名患者为孤立性跖骨骨折,30名患者为多发性骨折。患者的平均年龄为 45 ± 15.2 岁,其中男性 48 人(占 43%),女性 63 人(占 57%)。孤立跖骨骨折患者的 FAOS 为 88 ± 17.1,而多发性跖骨骨折患者的 FAOS 为 78 ± 17.7(P = 0.046)。在孤立跖骨骨折组中,43 名患者(53%)接受了手术治疗,其中 36 名患者的骨折类型为 C 型(84%)。在多发性跖骨骨折组中,16 名患者(53%)接受了手术治疗:总的来说,孤立性跖骨骨折经过手术和保守治疗后,功能效果良好或非常好。简单的骨折可以成功地进行保守治疗,复杂的多段骨折可以安全地进行手术治疗。如果有一块以上的跖骨骨折,功能效果就会大打折扣,患者的活动范围和僵硬程度都会受到长期限制。
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来源期刊
Unfallchirurg
Unfallchirurg 医学-急救医学
CiteScore
1.50
自引率
0.00%
发文量
69
审稿时长
4-8 weeks
期刊介绍: Der Unfallchirurg is an internationally recognised publication organ. The journal deals with all aspects of accident surgery and reconstruction surgery and serves the continuing medical education of surgeons and accident surgeons with own practices and those working in hospitals. Practically-oriented works provide an overview on selected topics and offer the reader a summary of current findings from all fields of accident surgery. Besides the imparting of relevant background knowledge, the focus is on the assessment of scientific findings under consideration of practical experience. The reader is given concrete recommendations for his/her practical work.
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