Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Orthopedic Surgery

Background: Displaced intra-articular zone I and displaced zone II fractures of the proximal fifth metatarsal bone are frequently complicated by delayed nonunion due to a vascular watershed. Many complications have been reported with the commonly used intramedullary screw fixation for these fractures. The optimal surgical procedure for these fractures has not been determined. All these observations led us to evaluate the effectiveness of bicortical screw fixation for treating these fractures. {u2022}Methods: The prospective study included 20 patients with acute fractures of the base of the fifth metatarsal fractures operatively treated by bicortical screw fixation. All the fractures were evaluated both clinically using the AOFAS score and radiologically for the assessment of healing. All the patients were followed at 2 or 3 week intervals till fracture union. The patients were followed for an average of 5.95 months.Results: Twenty fractures healed uneventfully following bicortical fixation, with a mean healing time of 6.8 weeks (range, 6 to 8 weeks).The average American Orthopaedic Foot & Ankle Society (AOFAS) score was 87 (range, 80 to 90). All the patients reported no pain at rest or during athletic activity. There was no refracture in any of our cases

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