Abstract：
BACKGROUND:Identifying the optimal starting point for intramedullary fixation of tibia and femur fractures is well described in the literature using a retrograde or anterograde technique. This technique has not been applied to the fifth metatarsal, where screw trajectory can cause iatrogenic malreduction. The generally accepted starting point for the fifth metatarsal is "high and inside" to accommodate the fifth metatarsal's dorsal apex and medial curvature. We used a retrograde technique to identify the optimal starting position for intramedullary fixation of fifth metatarsal fractures. METHODS:Five matched cadaveric lower extremity pairs were dissected to the fifth metatarsal neck. An osteotomy was made to access the intramedullary canal. A retrograde reamer was passed to the base of the fifth metatarsal to ascertain the ideal entry point. Distances from each major structure on the lateral aspect of the foot were measured. Computed tomography scans helped assess base edge measurements. RESULTS:In 6 of 10 specimens, the retrograde reamer hit the cuboid with a cuboid invasion averaging 0.7 mm. The peroneus brevis and longus were closest to the starting position with an average distance of 5.1 mm and 5.7 mm, respectively. Distances from the entry point to the dorsal, plantar, medial, and lateral edges of the metatarsal base were 8.3 mm, 6.9 mm, 9.7 mm, and 9.7 mm, respectively. CONCLUSION:Optimal starting position was found to be essentially at the center of the base of the fifth metatarsal at the lateral margin of the cartilage. Osteoplasty of the cuboid or forefoot adduction may be required to gain access to this site. CLINICAL RELEVANCE:This study evaluated the ideal starting position for screw placement of zone II base of the fifth metatarsal fractures, which should be considered when performing internal fixation for these fractures.
journal_name
Foot Ankle Intjournal_title
Foot & ankle internationalauthors
Watson GI,Karnovsky SC,Konin G,Drakos MCdoi
10.1177/1071100717702688subject
Has Abstractpub_date
2017-07-01 00:00:00pages
802-807issue
7eissn
1071-1007issn
1944-7876journal_volume
38pub_type
杂志文章abstract：BACKGROUND:External rotation stress (ERS) identifies ankle instability after fibular reduction of rotational ankle injuries. Combined hindfoot and ankle motions and an inconsistent starting position could mask differing degrees of instability resulting from syndesmotic and/or deltoid ligament disruption. The goal of th...
journal_title：Foot & ankle international
pub_type： 杂志文章
doi：10.1177/1071100719840993
更新日期：2019-07-01 00:00:00
abstract：:Although most authors recommend either 3.5-mm or 4.5-mm cortical screws for syndesmosis fixation, the optimum screw size has yet to be defined. The present study was designed to biomechanically compare syndesmosis fixation with 3.5-mm and 4.5-mm stainless steel screws. Simulated pronation external rotation ankle injur...
journal_title：Foot & ankle international
pub_type： 杂志文章
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abstract：:Contemporary methods of bone grafting osteochondral defects, in which the remaining overlying cartilage is relatively well preserved, have inherent problems. The bony defects are often saucer-shaped and the cylindrical graft may not fill the void, leaving areas of cartilage with no underlying scaffold and obviating ea...
journal_title：Foot & ankle international
pub_type： 杂志文章
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abstract：BACKGROUND:This retrospective comparative study reports the practical function in daily and sports activities after tibialis posterior tendon transfer for foot drop secondary to peroneal nerve palsy. METHODS:Seventeen patients were followed for a minimum of 3 years after tibialis posterior tendon transfer for foot dro...
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abstract：:Seven fresh-frozen cadaver specimens had a calcaneal osteotomy performed obliquely through the posterior portion of the calcaneus. Angular relationships between the first metatarsal and talus were recorded with the use of a motion-analysis system in the transverse, sagittal, and coronal planes. The specimen was mounte...
journal_title：Foot & ankle international
pub_type： 杂志文章
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abstract：BACKGROUND:The purpose of this study was to assist surgeons treating calcaneal fractures in choosing the most predictive fracture classification and clinical outcome tool. MATERIALS AND METHODS:For 152 patients (189 calcaneal fractures; average followup, 9.9 years), all fractures were classified in accordance with the...
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abstract：BACKGROUND:Subtalar bone-block distraction arthrodesis using structural autograft carries the risk of donor site morbidity. Recent reports suggest that structural allograft may be an attractive alternative to structural autograft in subtalar arthrodesis. This prospective study analyzes subtalar distraction arthrodesis ...
journal_title：Foot & ankle international
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abstract：BACKGROUND:Over the past decade, total ankle arthroplasty (TAA) has become a mainstay in the treatment of end-stage ankle arthritis. Currently in its fourth generation, the Scandanavian Total Ankle Replacement (STAR) is the only 3-piece mobile bearing ankle prosthesis available in the United States. Our current study r...
journal_title：Foot & ankle international
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abstract：BACKGROUND:Fixed equinovarus deformities can be challenging to treat especially in medically debilitated patients. The purpose of this study was to evaluate Achilles lengthening with posterior tibial tenotomy and immediate weightbearing in this difficult group of patients. MATERIALS AND METHODS:Thirteen extremities in...
journal_title：Foot & ankle international
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pub_type： 临床试验,杂志文章
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journal_title：Foot & ankle international
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更新日期：1996-07-01 00:00:00
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