Effectiveness of mini locking plate combined with Kirschner wire in treatment of comminuted Jones fracture_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 YAN Rongliang , QU Jiafu , CAO Lihai , LIU Hongda , CHEN Jianghua , GAO Yan , PENG Yi

Department of Foot and Ankle Surgery, the Second Hospital of Tangshan City, Tangshan Hebei, 063000, P.R.China;

Corresponding?author：

YAN Rongliang, Email: yanrongliang8@sina.com

Keywords：

Jones fracture; mini locking plate; Kirschner wire; internal fixation

DOI：

10.7507/1002-1892.201711104

Video：

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ObjectiveTo summarize the effectiveness of mini locking plate combined with Kirschner wire in treatment of comminuted Jones fracture.MethodsBetween January 2011 and October 2016, 25 cases with comminuted Jones fracture were treated with mini locking plate combined with Kirschner wire. There were 9 males and 16 females with an average age of 31.4 years (range, 16-66 years). The fractures located on the left side in 11 cases and on the right side in 14 cases. The causes of injury included spraining in 21 cases, falling down in 3 cases, and bruise in 1 case. The bone fragment of all cases was more than 3 pieces. The fracture line was mostly Y-shape or T-shape. Twelve of them were combined with other fractures. The time from injury to operation was 1-9 days (mean, 5 days). The mini locking plate and Kirschner wire were removed at 9-12 months postoperatively. At 12 months postoperatively, the pain was evaluated by the visual analogue scale (VAS) score, and the function by the American Orthopaedic Foot & Ankle Society (AOFAS) score.ResultsAll incisions healed by first intention. All cases were followed up 12-36 months with an average of 21.7 months. Fracture union was observed in all patients without complications such as nonunion, delayed union, and malunion. The fracture union time was 8-12 weeks (mean, 9.4 weeks). At 12 months postoperatively, the VAS score was 1.15±0.87; the AOFAS score was 89.45±6.24, and the results were excellent in 14 cases, good in 9 cases, fair in 1 case, and poor in 1 case, with an excellent and good rate of 92%.ConclusionThe procedure of mini locking plate combined with Kirschner wire for comminuted Jones fracture has such advantages as convenient operation, more rigid fixation, high rate of fracture healing, and good functional recovery in foot.

Citation： YAN Rongliang, QU Jiafu, CAO Lihai, LIU Hongda, CHEN Jianghua, GAO Yan, PENG Yi. Effectiveness of mini locking plate combined with Kirschner wire in treatment of comminuted Jones fracture. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(5): 587-590. doi: 10.7507/1002-1892.201711104 Copy

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1. Zwitser EW, Breederveld RS. Fractures of the fifth metatarsal: diagnosis and treatment. Injury, 2010, 41(6): 555-562.
2. Polzer H, Polzer S, Mutschler W, et al. Acute fractures to the proximal fifth metatarsal bone: development of classification and treatment recommendations based on the current evidence. Injury, 2012, 43(10): 1626-1632.
3. Stewart IM. Jones’s fracture: fracture of base of fifth metatarsal. Clin Orthop Relat Res, 1960, 16: 190-198.
4. Lawrence SJ, Botte MJ. Jones’ fractures and related fractures of the proximal fifth metatarsal. Foot Ankle, 1993, 14(6): 358-365.
5. Jones R. Fracture of the base of the fifth metatarsal bone by indirect violence. Ann Surg, 1902, 35(6): 697-700.2.
6. Richi WR, Rosenthal DI. Avulsion fracture of the fifth metatarsal: experimental study of pathomechanics. AJR Am J Roentgenol, 1984, 143(4): 889-891.
7. Fetzer GB, Wright RW. Metatarsal shaft fractures and fractures of the proximal fifth metatarsal. Clin Sports Med, 2006, 25(1): 139-150, x.
8. Dameron TB Jr. Fractures of the proximal fifth metatarsal: selecting the best treatment option. J Am Acad Orthop Surg, 1995, 3(2): 110-114.
9. Smith JW, Arnoczky SP, Hersh A. The intraosseous blood supply of the fifth metatarsal: implications for proximal fracture healing. Foot Ankle, 1992, 13(3): 143-152.
10. McKeon KE, Johnson JE, McCormick JJ, et al. The intraosseous and extraosseous vascular supply of the fifth metatarsal: implication for fifth metatarsal osteotomy. Foot Ankle Int, 2013, 34(1): 117-123.
11. Mologne TS, Lundeen JM, Clapper MF, et al. Early screw fxation versus casting in the treatment of acute Jones fractures. Am J Sports Med, 2005, 33(7): 970-975.
12. Quill GE Jr. Fractures of the proximal fifth metatarsal. Orthop Clin North Am, 1995, 26(2): 353-361.
13. Porter DA, Duncan M, Meyer SJ. Fifth metatarsal Jones fracture fixation with a 4.5-mm cannulated stainless steel screw in the competitive and recreational athlete: a clinical and radiographic evaluation. Am J Sports Med, 2005, 33(5): 726-733.
14. Mindrebo N, Shelbourne KD, Van Meter CD, et al. Outpatient percutaneous screw fixation of the acute Jones fracture. Am J Sports Med, 1993, 21(5): 720-723.
15. Shereff MJ, Yang QM, Kummer FJ, et al. Vascular anatomy of the fifth metatarsal. Foot Ankle, 1991, 11(6): 350-353.
16. Lee SK, Park JS, Choy WS. LCP distal ulna hook plate as alternative fixation for fifth metatarsal base fracture. Eur J Orthop Surg Traumatol, 2013, 23(6): 705-713.

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Effectiveness of mini locking plate combined with Kirschner wire in treatment of comminuted Jones fracture

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