This could be the reason for reduced regenerative capacity of the bone tissue in this particular spot, which makes it difficult for micro-injuries to regenerate. The main reason of increased probability for a stress fracture in this area is its very limited blood supply. In this zone both acute and stress fractures occur. Basically, this type of the fracture relates to an injury approximately 1.5 cm from bone tuberosity. Some discrepancies may be found due to diverging definitions of Jones fractures among different authors ( Baumbach et al., 2017). Stress fractures mainly affect the shaft of the bone ( Mayer et al., 2014). Stress fractures are the fallout of the accumulation of overloads which are not able to cause injury independently, but their multiplication leads to weakening of the bone tissue and in consequence, to its fracture. They differentiate between three types of fractures in the proximal part of the 5 th metatarsal bone: the tuberosity avulsion fracture, the Jones' fracture and the proximal diaphyseal stress fracture.Īn avulsion fracture is an injury which occurs as a result of a rapid pull (usually the consequence of a sudden stop), a fracture emerging near the epiphysis of the bone along with a bone fragment detachment ( Bowes and Buckley, 2016). The literature concentrates on a few particular divisions of 5 th metatarsal fractures, the most popular of which seems to be the one proposed by Lawrence and Botte (1993). The challenge often is the diagnosis itself, and most notably determining the correct type of the fracture. Fractures most often affect the base of the 5 th metatarsal and make for 40 to 75% of all foot fractures ( Wang et al., 2020). Early limb loading after surgery (from week 2) does not delay fracture healing or hinder the bone union, thus rehabilitation plays a crucial role in shortening the time of RTP (return to play) and is obligatory for each athlete who undergoes surgical treatment.Ī fracture of the 5 th metatarsal bone is a specific problem of people who are permanently exposed to foot overload, including athletes. Prompt fracture stabilization surgery is recommended for athletes, enabling the implementation of an aggressive rehabilitation protocol as soon as possible. The total inability to play lasted for 9.2 (± 1.86) weeks among players treated only surgically (n = 10), 17.5 (± 2.5) weeks in the conservative and later surgery group, excluding players with nonunion (n = 6), and 24.5 (± 10.5) weeks for nonunion and switch treatment (n = 4) players. All players underwent standard percutaneous internal fixation with the use of cannulated screws. We followed the surgical and rehabilitation path of 21 professional soccer players from the Polish League (I st and II nd divisions) who suffered from the 5 th metatarsal bone fracture. The main purpose of the analysis was to determine the minimum time necessary for a permanent return to the sport after a 5 th metatarsal fracture among professional soccer players. This manuscript presents the treatment and rehabilitation of professional soccer players who had acute fractures of the 5th metatarsal bone and a cannulated screw fixation. The 5 th metatarsal fracture is a common foot fracture which could exclude a player from competition for several months and significantly affect his or her career.
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