Abstract
Objective To evaluate the surgical result of zone-2 and -3 fractures of the base of the fifth
metatarsal bone using partially-threaded cancellous screws with a diameter of 4.0
mm.
Materials and Methods A retrospective evaluation of patients submitted to surgery between 2010 and 2019.
We included all of the cases synthesized with this device with a minimum follow-up
of three months, and excluded the cases operated on with other devices and follow-up
shorter than three months. We evaluated the consolidation and the presence of complications,
and determined, screw length, diameter of the endomedullary canal, the distance between
the proximal edge of tuberosity and the fracture, and thread pitch over the fracture
line on anteroposterior (AP) and oblique radiographs.
Results We evaluated 39 cases, and the sample had an average age of 27 years and male predominance.
The most used screw length was 45 mm, and the average diameters of the medullary canal
measured on the AP and oblique radiographs were of 4.6 mm and 3.96 mm respectively.
The distance from the edge of the tuberosity to the fracture was of 25.8 mm, and the
thread pitch over the fracture line was on average 24 mm. The rate of consolidation
was of 100%, occurring in an average of 9.4 weeks, and there were 3 cases of consolidation
delay, 2 of screw recoil, 1 of intrafocus thread, and 1 of superior cortex fracture.
To date, there have been no cases of screw removal.
Discussion There is no consensus regarding the ideal screw. The international literature recommends
intramedullary devices with a diameter of at least 4.5 mm. There are few reports of
the use of screws with 4.0 mm in diameter.
Conclusions The partially-threaded cancellous screw with a diameter of 4.0 mm is an effective
and safe option, with a low complication rate for the management of these fractures.
Keywords
tarsal joints/injury - metatarsal bones/injury - foot injuries/surgery - fractures
