Curative effect analysis of locking compression plate distal ulna hook plate for fractures of the iffth metatarsal base

HUANG Xiao-nan; SHEN Ming-jie; FAN Meng

doi:10.3969/j.issn.2095-252X.2015.02.012

Abstract：Objective To assess the clinical and radiological outcomes of locking compression plate distal ulna hook plate ( LCP-DUHP ) for fractures of the 5th metatarsal base. Methods From March 2010 to March 2012, 29 consecutive patients with fractures of the 5th metatarsal base were treated with LCP-DUHP. There were a total of 23 cases with complete follow-up data. There were 12 males and 11 females, whose mean age was 47 years old ( range:20-75 years ). As to the mechanism of injuries, falling on the ground occurred in 13 cases, a bicycle accident in 5 cases, a trafifc accident in 3 cases and high falling in 2 cases. Preoperatively, all the patients had foot and ankle swelling, pain and restricted movement. No open fractures were noticed. According to Lawrence-Botte, 18 patients had zone I fractures and 5 patients had zone II fractures. The mean period from injury to surgery was 2 days ( range:1-5 days ). The patients were followed up regularly after the operation, and the time of union, functional recovery and incidence of complications ( such as infection, delayed union, nonunion, refracture and traumatic arthritis ) were assessed. The functional outcomes were graded using the American Orthopaedic Foot and Ankle Society ( AOFAS ) midfoot scoring system. Results All the 23 patients were followed up for a mean period of 14 months ( range:11-22 months ). The incisions were primary healing in all the patients. The mean interval to partial weightbearing was 4 weeks ( range:3-6 weeks ), and the mean interval to full weightbearing was 7 weeks ( range:5-16 weeks ). All the patients returned to their regular daily lives at a mean period of 11 weeks after the surgery ( range:8-18 weeks ). In the latest follow-up, the mean AOFAS midfoot score was 94 points ( range:72-100 points ). The postoperative follow-up data showed excellent outcomes in 19 patients, good outcomes in 3 patients and fair outcomes in 1 patient. The good and excellent rate was 95.7%. Immediately postoperative plain radiographic images showed that satisfactory reduction was achieved in all the patients. Bony union was obtained at a mean period of 7.6 weeks ( range:4-16 weeks ). No ununion or malunion was found. One patient ( 4.3%) had delayed union, who achieved union at 4 weeks after plaster immobilization. Mild degenerative changes in the plantar and calcaneocuboid joint was detected in 3 patients ( 13.0%) in the latest follow-up. Conclusions Satisfacoty clinical and radiological outcomes can be achieved in the treatment of fractures of the 5th metatarsal base by LCP-DUHP, and this internal ifxation method is worthy of clinical application.