Lawrence SJ, Botte MJ: Jones' fractures and related fractures of the proximal fifth metatarsal. Foot Ankle 14: 358, 1993.
Torg JS: Fractures of the base of the fifth metatarsal distal to the tuberosity. Orthopedics 13: 731, 1990.
Egol K, Walsh M, Rosenblatt K, et al: Avulsion fractures of the fifth metatarsal base: a prospective outcome study. Foot Ankle Int 28: 581, 2007.
Petrisor BA, Ekrol I, Court-Brown C: The epidemiology of metatarsal fractures. Foot Ankle Int 27: 172, 2006.
Lee KT, Park YU, Young KW, et al: Surgical results of 5th metatarsal stress fracture using modified tension band wiring. Knee Surg Sports Traumatol Arthrosc 19: 853, 2011.
Lee SK, Park JS, Choy WS: Locking compression plate distal ulna hook plate as alternative fixation for fifth metatarsal base fracture. J Foot Ankle Surg 53: 522, 2014.
Sarimo J, Rantanen J, Orava S, et al: Tension-band wiring for fractures of the fifth metatarsal located in the junction of the proximal metaphysis and diaphysis. Am J Sports Med 34: 476, 2006.
Thomas JL, Davis BC: Three-wire fixation technique for displaced fifth metatarsal base fractures. J Foot Ankle Surg 50: 776, 2011.
Mahajan V, Chung HW, Suh JS: Fractures of the proximal fifth metatarsal: percutaneous bicortical fixation. Clin Orthop Surg 3: 140, 2011.
Renner C, Whyte J, Singh S, et al: Treatment of fractures of the fifth metatarsal with the XS-nail retrospective study and comparison with tension-band wiring. Arch Orthop Trauma Surg 130: 1149, 2010.
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 43: 1626, 2012.
Zwitser EW, Breederveld RS: Fractures of the fifth metatarsal: diagnosis and treatment. Injury 41: 555, 2010.
DeVries JG, Taefi E, Bussewitz BW, et al: The fifth metatarsal base: anatomic evaluation regarding fracture mechanism and treatment algorithms. J Foot Ankle Surg 54: 94, 2015.
Rosenberg GA, Sferra JJ: Treatment strategies for acute fractures and nonunions of the proximal fifth metatarsal. J Am Acad Orthop Surg 8: 332, 2000.
Mofidi A, Hamer P, Thomas RH, et al: Stress fracture of the fifth metatarsal base caused by tension band wiring: an isolated case report. Foot Ankle Spec 2: 79, 2009.
Rammelt S, Schneiders W, Schikore H, et al: Primary open reduction and fixation compared with delayed corrective arthrodesis in the treatment of tarsometatarsal (Lisfranc) fracture dislocation. J Bone Joint Surg Br 90: 1499, 2008.
Choi JH, Lee KT, Lee YK, et al: Surgical results of zones I and II fifth metatarsal base fractures using hook plates. Orthopedics 36: E71, 2013.
Vu D, McDiarmid T, Brown M, et al: Clinical inquiries: what is the most effective management of acute fractures of the base of the fifth metatarsal? J Fam Pract 55: 713, 2006.
Larson CM, Almekinders LC, Taft TN, et al: Intramedullary screw fixation of Jones fractures: analysis of failure. Am J Sports Med 30: 55, 2002.
Fansa AM, Smyth NA, Murawski CD, et al: The lateral dorsal cutaneous branch of the sural nerve: clinical importance of the surgical approach to proximal fifth metatarsal fracture fixation. Am J Sports Med 40: 1895, 2012.
Donley BG, McCollum MJ, Murphy GA, et al: Risk of sural nerve injury with intramedullary screw fixation of fifth metatarsal fractures: a cadaver study. Foot Ankle Int 20: 182, 1999.
The distal ulna hook plate was recently introduced for the treatment of fifth metatarsal base fractures, but no special articles have reported the surgical results of the plate fixation of displaced or comminuted fifth metatarsal base fractures in zone 1, which are the most common forefoot fractures.
Twenty-one patients with Lawrence classification zone 1 fifth metatarsal base fractures with extra-articular displacement greater than 2 mm (n = 13) and intra-articular displacement fractures (n = 8) were included in the study. Patients were treated with the distal ulna hook plate. Patients were evaluated clinically and radiographically, and the functional outcomes were graded using the American Orthopaedic Foot and Ankle Society midfoot scoring system. Time to union and return to pre-injury levels of activity were calculated.
Mean American Orthopaedic Foot and Ankle Society midfoot scores were 42.25 points (range, 27–55 points) preoperatively and 93.16 points (range, 87–100 points) 1 year postoperatively. Mean time to complete union was 61.9 days (range, 52–85 days). Nineteen patients reported returning to previous activities of daily living at a mean of 79.8 days (range, 59–91 days). Two patients showed radiographic signs of mild degenerative changes and noted mild pain, and one patient experienced hardware irritation.
The distal ulna hook plate might be considered an effective surgical method for zone 1 displaced fifth metatarsal base fractures or multifragmentary, osteoporotic fifth metatarsal base fractures.