Title : Surgical management of spiral oblique fractures of the fifth metatarsal leads to faster return to play in athletes: A systematic review
Abstract:
Purpose: The purpose of this systematic review was to evaluate outcomes following both operative and non-operative management of spiral oblique fractures of the 5th metatarsal.
Methods: During November 2023, the PubMed, Embase and Cochrane library databases were systematically reviewed to identify clinical studies examining outcomes following operative and non-operative management of dancer's fractures. Data regarding subjective clinical outcomes, radiological outcomes, complications and failure rates were extracted and analyzed.
Results: Ten studies were included in this review. In total, 125 patients underwent operative treatment for dancer's fractures and 365 patients underwent non-operative treatment for dancer's fracture. The weighted mean follow-up in the operative cohort was 15.3 ± 32.7 months and the weighted mean follow-up in the non-operative cohort was 30.6 ± 24.3 months. The union rate in the operative cohort was 99.2% and the union rate in the non-operative cohort was 98.6%. The weighted mean time to return to sport was 15.4 ± 6.7 and 22.4 ± 4.4 weeks in the operative cohort and nonoperative cohort, respectively. The complication rate in the operative cohort and non-operative cohort was 12.0% and 15.9%, respectively.
Conclusion: This current systematic review demonstrated comparable radiographic outcomes together with low failure rate and low complication rate following both operative and non-operative management of dancer’s fracture at short-term follow-up. However, faster return to sport rates were observed in the operative cohort, suggesting that surgical management of displaced spiral oblique fractures of the 5th metatarsal should be the mainstay treatment option. Nonetheless, the under-reporting of data, marked heterogeneity between studies and paucity of comparative studies limits the generation of any robust conclusions, thus further high-quality comparative studies are warranted.
What will audience learn from your presentation?
(Try to list 3-5 specific items)
- This presentation will optimize the management of the dancer’s fractures, especially in athletes
- This systematic review empowers practitioners to consider surgical intervention as a potentially more efficient treatment
- It provides information about faster return to sport after operative management and could inform design decisions in fields related to orthopedics or sports equipment
