The primary aim of this study was to assess the VAS FA after an average of 5 years following functional treatment of any type I and II fracture. Values of 50 are representative for a healthy population, with higher scores representing a better outcome. Published reference values for healthy controls are 86 to 100 for “Overall,” 82 to 100 for “Pain,” 87 to 100 for “Function,” and 68 to 83 for “Other.” 28 The SF-12, one of the most commonly applied general quality-of-life tools, has 2 meta-scores: the Physical Component Summary (PCS) and Mental Component Summary (MCS). 23, 28 Scores range from 0 to 100 points. The VAS FA is a 20-item foot and ankle outcome measure, with an overall score (Overall) and 3 subscales (Pain, Function, Other). Patient-rated outcome measures (PROMs) were assessed prospectively, namely, the visual analog scale for foot and ankle (VAS FA) 23 and the SF-12. This treatment regimen was applied to all patients, independent of the fracture characteristics, namely, number of fragments, displacement, or articular involvement.ĭemographic data, fracture location per Lawrence and Botte 16 (type I or II) and fracture characteristics (number of fragments, displacement, intra-articular involvement ) were assessed retrospectively. Radiological follow-up was performed only if patients were symptomatic after 6 weeks. ![]() No routine radiological follow-up was performed. 3, 22 Immobilization was performed only if requested by the patient but for a maximum of 14 days. 3 For the current study, all 95 patients were contacted again.Īll patients who sustained an acute, isolated epi-metaphyseal fracture (types I and II) were treated functionally by full weightbearing as tolerated, as outlined previously. Of those, 39 (41%) could be followed up after 2 years. 3 In summary, the database included 95 patients meeting the inclusion criteria (acute, isolated epi-metaphyseal fracture, >17 years old, functional treatment). 3 The detailed patient selection process for the 5th MT registry has been described previously. The 2-year patient-rated outcome has been published previously. The study was approved by the local ethics committee. As all type I and II fractures were included and no intervention was applied, this study can be considered a natural history study. This was a retrospective, longitudinal database study, with a prospective 5-year follow-up. 3 The aim of the current study was to assess the midterm outcome for functionally treated epi-metaphyseal fractures of the 5th MT bone (types I and II). We previously published promising 2-year results following functional treatment of any epi-metaphyseal proximal 5th MT fracture. We have treated all patients with an acute epi-metaphyseal fracture (type I or II) functionally with full weightbearing and free range of motion since 2012. 6, 9, 15 Again, mid- to long-term results are missing. 8, 16, 19, 20 Some authors, on the other hand, have hypothesized that functional treatment can lead to favorable results. 2, 3, 8, 22 While there is strong evidence supporting operative treatment for type III fractures, 18 recommendations for type II fractures vary from immobilization and nonweightbearing to operative treatment. Studies on type II fractures are rare because of the inconsistent use of the term Jones fracture, which has been used synonymously for both type II and III fractures. Consequently, we are still missing mid- and long-term results for displaced, intra-articular, and comminuted type I fractures. ![]() 3, 9, 29 Unfortunately, these studies presented only short-term follow-up (20 weeks to 2 years). ![]() 4, 11, 16, 19, 34 Few studies have actually analyzed the influence of those fracture characteristics on patient-reported outcome. 33 These recommendations are not based on evidence but rather reflect single authors’ opinions. ![]() Surgical indications for type I fractures have varied in the literature, but they have included some of the following: displacement of ≥2 mm, involvement of more than 30% of the articular surface, or comminution. Schematic illustration of the Lawrence and Botte 16 classification.
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