- Volume 14 Issue 2
Contribution of Lateral Ankle Instability Evaluation with MRI to Proximal Fifth Metatarsal Fracture
제5 중족골 근위부 골절 환자의 자기공명영상 검사를 통한 족관절 외측 불안정성 평가의 기여도
- Yoo, Jong-Min (Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine) ;
- Chu, In-Tak (Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine) ;
- Lee, Kyu-Jo (Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine)
- Received : 2010.10.07
- Accepted : 2010.11.18
- Published : 2010.12.15
Purpose: One of the main contributors to proximal fifth metatarsal fracture is ankle inversion and the incidence of recurrence may increase in patients with ankle instability. So, the authors confirmed the patients of proximal fifth metatarsal fracture with ankle instability by checking the history and magnetic resonance imaging (MRI) and assessed the value of MRI as therapeutic prognosis and clinical indicators for prevention of recurrence. Materials and Methods: Patients with proximal fifth metatarsal fractures visited our hospital during recent five years were reviewed. 35 patients with suspected damage by ankle inversion had been identified a history of ankle instability and checked the hindfoot malalignment through hindfoot alignment view and MRI was performed prospectively. The patients was devided to three groups on the location of fracture site and the groups were compared each other. Results: The mean time from injury to checking MRI was 10.7 days. There was no structural abnormality and was no significant difference according to the location of fracture. The patients with history of ankle inversion were 31(88.6%) and the patients with history of chronic or recurrent injury were 22 patients (62.9%). The lesion of MRI related to lateral ankle instability were identified in all patients. Conclusion: This study noted a high incidence of lateral ankle instability that was identified by MRI in the patients of proximal fifth metatarsal fracture. Aggressive treatment for lateral ankle instability should be needed for complications as proximal fifth metatarsal fracture to reduce the recurrence and occurrence.
- Raikin SM, Slenker N, Ratigan B. The association of a varus hindfoot and fracture of the fifth metatarsal metaphyseal-diaphyseal junction: the Jones fracture. Am J Sports Med. 2008;367:1367-72.
- Dameron TB Jr. Fractures and anatomical variations of the proximal portion of the fifth metatarsal. J Bone Joint Surg Am. 1975;57:788-92.
- Petrisor BA, Ekrol I, Court-Brown C. The epidemiology of metatarsal fractures. Foot Ankle Int. 2006;27:172-4.
- Joshy S, Abdulkadir U, Chaganti S, Sullivan B, Hariharan K. Accuracy of MRI scan in the diagnosis of ligamentous and chondral pathology in the ankle. Foot Ankle Surg. 2010;16:78-80. https://doi.org/10.1016/j.fas.2009.05.012
- Dameron TB Jr. Fractures of the proximal fifth metatarsal: selecting the best treatment option. J Am Acad Orthop Surg. 1995;3:110-4.
- Vaes P, Duquet W, van Gheluwe B. Peroneal reaction times and eversion motor response in healthy and unstable ankles. J Athl Train. 2002;4:475-80.
- Karlsson J, Eriksson BI, Sward L. Early functional treatment for acute ligament injuries of the ankle joint. Scand J Med Sci Sports.1996;6:341-5.
- Becker HP, Rosenbaum D. Chronic recurrent ligament instability on the lateral ankle. Orthopade 1999;28:483-92.
- Quill GE Jr. Fractures of the proximal fifth metatarsal. Orthop Clin North Am. 1995;26:353-61.
- Bonnel F. Chronic ankle instability: biomechanics and pathomechanics of ligaments injury and associated lesions. Orthop Traumatol Surg Res. 2010;96:424-32. https://doi.org/10.1016/j.otsr.2010.04.003
- de Vries JS, Kerkhoffs GM, Blankevoort L, van Dijk CN. Clinical evaluation of a dynamic test for lateral ankle ligament laxity. Knee Surg Sports Traumatol Arthrosc. 2010;18:628-33. https://doi.org/10.1007/s00167-009-0978-7