Measurement of the results of functional treatment of metatarsal fractures using the AOFAS scale and the duration of work incapacity

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• 作者：I. Ú ; beda Pé ; rez de Heredia ; ^{dr.iubedap@gmail.com} ; ^{inigo_ubeda@fremap.es} ; J.I. Mart&iacute ; nez de Renobales ; J. Garc&iacute ; a D&iacute ; az ; F.J. Otañ ; o Aranguren ; I. Sá ; nchez Zapirain
• 关键词：Metatarsal ; Fracture ; Weight bearing ; Treatment ; Conservative ; Functional
• 刊名：Revista Espa?ola de Cirugía Ortopédica y Traumatología (English Edition)
• 出版年：2012
• 期刊代码：pca312_19888856
• 类别：med
• 出版时间：March-April, 2012
• 卷：56
• 期：2
• 页码：132-139
• 文件大小：759 K

摘要

Objective

To demonstrate the effectiveness of functional treatment for the fractures of the metatarsal, which consisted of immediate or early weight bearing without immobilisation.

Material and methodology

We prospectively studied 276 patients with simple or complex fractures of the metatarsal, treated with a functional method which consisted of immediate (before the 3rd day since the fracture) or early (between 3rd and 21st day) effective weight bearing.

Inclusion criteria were patients aged 16-65, both sexes, diagnosed with isolated or multiple, closed or opened type I metatarsal fractures who did weight bearing exercises during the first 21 days.

We analysed the effects of the steroid injection proposed for this treatment in the focus of the fracture, the days of weight bearing, rehabilitation and number of metatarsal fractures.

Results were evaluated using AOFAS (American Orthopaedic Foot and Ankle Society) scores, days of work incapacity and complications of the treatment.

Results

The AOFAS score for patients treated functionally was excellent and we found few complications with it.

Discussion

The functional method is based on the function of ligaments and muscles of the forefoot and the aid of a rigid-soled shoe which allows early weight-bearing to avoid secondary displacement of the fractures.

The results show that immediate weight bearing provides better results than delayed bearing. Injection of steroid does not appear to have any benefit.

Conclusions

We propose the functional method for all closed displaced or non-displaced metatarsal fractures, except for the displaced fractures on the base of the fifth metatarsal.