Treatment of Acute Type I Proximal Fifth Metatarsal Fractures; 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



Introduction: The acute type I proximal fifth metatarsal fracture is one of the most common fractures of the small bones of the foot. The current study aimed to compare the results of two non-invasive treatment methods namely casting with ultrasound and bracing with ultrasound.
Methods: Patients with acute type I proximal fifth metatarsal fracture were divided into two groups namely casting and bracing based on a randomized complete block design and were followed at six, 12, and 18 weeks. The variables studied included age, gender, body mass index (BMI), mechanism of trauma, sports activity level, visual analogs scale (VAS), re-fracture, nonunion, the average time to clinical and radiographic union, as well as AOFAS (the American Orthopedic Foot and Ankle Society hind-foot) and short form-36 satisfaction scores, which were collected via questionnaires by the participant and the physician.
Results: Of 117 patients, 57 were treated by casting and 60 by bracing and were followed up for 18 weeks. The mean age of patients was 27.5 ± 1.25 years. There were no significant differences between the groups at the time of radiographic and clinical union, degree of AOFAS at all-time points, and the level of pain at 12 and 18-week follow-ups. The VAS score in the casting group was lower than that of the bracing group at the six-week follow-up. The mean times for radiographic and clinical union in both groups were 70 and 40-41 days respectivly. Based on SF-36, the level of satisfaction was higher at all time points with bracing.
Conclusion: According to the results of this study, both methods used had acceptable results, but, given the greater satisfaction reported by the subjects in the bracing group, it seems that the bracing is an appropriate alternative to the casting technique in the treatment of this type of fracture.