Treatment of Acute Type I Proximal Fifth Metatarsal Fracture; Casting vs Bracing

Document Type : Original Article


1 Ghaem clinical Research and Development Unit, Guilan University of Medical Science, Rasht, Iran

2 Department of Anatomical Sciences & Cell Biology, Mashhad University of medical sciences, Mashhad, Iran



After head trauma, pelvic fractures are the most common cause of death in patients with multiple trauma. The primary cause of death in patients with a pelvic fracture is uncontrollable bleeding, and in cases of delayed intervention, hemorrhagic shock is the principal cause of death. Bleeding from the external iliac artery following a Pelvic Ring and acetabulum fractures is an uncommon injury and an orthopedic emergency.
A 48-year-old man who experienced an accident trauma was referred to the hospital, and an APC‎ II of the Pelvic Ring‏ ‏and Acetabulum fractures were diagnosed. The patient developed thrombosis in the external iliac artery 48 hours after admission with a diagnosis of a lack of femoral pulse. CT angiography was performed for further examination. Then, in surgery, the anterior column of the acetabulum on the left side and symphysis disruption, an open reduction, and internal fixation with a reconstruction of 3.5 plates via a modified Stoppa approach was used. Sacroiliac disruption on the right side was repaired by percutaneous sacroiliac screw fixation. In the same session, the vascular repair was conducted via interposition graft of PTFE. After the treatment interventions, the patient's general condition was satisfactory, and he was discharged without any particular complication.
Due to the possibility of arterial injury in this trauma, the appropriate treatment can be done at the right time by checking pulses. While artery injuries are rare, they could be life-threatening.


Volume 27, Issue 2
March and April 2022
Pages 418-426
  • Receive Date: 14 April 2020
  • Revise Date: 19 January 2022
  • Accept Date: 16 March 2022
  • First Publish Date: 01 April 2022