Comparison of conservative treatment and full thread hollow screw for treatment of Ekrol 2 fracture of the fifth metatarsal bone

Abstract

Objective To compare the curative effect of conservative treatment and full thread hollow screw in the treatment of Ekrol 2 fracture of the fifth metatarsal bone. Methods From April 2013 to May 2015, 42 patients with avulsion fractures of the fifth metatarsal basement of type 2 fractures in Ekrol division were treated in our hospital. 23 patients underwent full thread hollow screw surgery (surgical treatment group), and there were12 males and 11 females, with an average age of 43.4±9.2 years, and the fracture displacement length was 2.3±0.2 mm. 19 patients treated with plaster fixation (conservative group), including 10 males and 9 females, with an average age of 45.7±8.9 years and fracture displacement length was 2.1±0.2 mm. During follow-up, X-ray examination was performed to evaluate the time of fracture healing and forefoot score of American Orthopaedic Foot and Ankle Society (AOFAS), visual analogue score (VAS) and quality of life questionnaire (SF-36) were compared between the two groups. Results All 42 patients were followed up for 12 to 24 months with an average of 18 months. At the latest follow-up, the fracture healing time of the surgical group was 9.3±2.0 weeks, with AOFAS score of 84.1±3.9, VAS score of 0.1±0.2, and the SF-36 score of 95.1±2.9 points, and the shortening of length after treatment was 2.1±2.5 mm; the average healing time of the conservative treatment group was 12.2±2.1 weeks, with the average AOFAS score of 84.2±4.2 points, and the average VAS score of 0.2±0.2 points, the average SF-36 score of 94.1±5.2 points, and the shortening of length after treatment was 0.4±2.5 mm. The results of each short-term score and the shortening of the length of the fracture after treatment was statistically significant. The results of the mid- and long-term scores showed no significant difference between the two groups; the fractures of both groups reached bone healing.3 cases of sural nerve stimulation occurred in the operation group, while 1 case occurred in the conservative group. Abnormal healing occurred in 2 cases of conservative treatment, and the fractures of the surgical treatment group were anatomic reduced. Conclusion Usingfull thread hollow screwfor the treatment of Ekrol 2 fracture of the fifth metatarsal bone is better than the con- servative treatment in the short term, but there is no significant difference in the long-term effect. Key words: Metatarsal bones; Fractures, bone; Fracture fixation, internal; Comparative study