Title : Evaluation of functional and radiological outcomes of percutaneous herbert screw fixation in jones fractures: A prospective study
Abstract:
Background: Jones fractures, occurring at the metaphyseal-diaphyseal junction of the fifth metatarsal, present a significant risk of delayed union or non-union due to the relative vascular watershed at the fracture site. In highly active individuals, surgical fixation is often preferred to expedite union and early return to function. This prospective study aimed to evaluate the clinical, functional, and radiological outcomes of percutaneous Herbert screw fixation in patients with Jones fractures.
Methods: This was a prospective study conducted at a tertiary trauma centre over 18 months. Thirty-three patients aged 18–60 years with isolated closed Jones fractures underwent percutaneous Herbert screw fixation. Functional outcomes were assessed using the Foot and Ankle Disability Index (FADI) at 1, 2, 3, and 6 months postoperatively. Radiological union was evaluated at 3 weeks, 6 weeks, 3 months, and 6 months via serial radiographs. Statistical analyses included Wilcoxon-Mann-Whitney U tests and Friedman tests, with significance set at p<0.05.
Results: The mean age of participants was 38.7 years, with a male predominance (54.5%). Radiological union was achieved in 84.8% by 6 weeks, 90.9% by 3 months, and 97% by 6 months. Functional scores (mean FADI) improved significantly over time: 61.58 at 1 month, 85.06 at 2 months, 92.06 at 3 months, and 93.55 at 6 months (p<0.001). The overall union rate was 94%, with a low complication rate (18.2%), including minor stiffness, chronic pain, and one case each of delayed union and non-union.
Conclusion: Percutaneous Herbert screw fixation in Jones fractures yields excellent union rates, accelerated functional recovery, and minimal morbidity. Early radiological union strongly correlated with improved FADI scores and earlier return to pre-injury activities.
Disclosure: The authors declare no conflicts of interest related to this study.
