The Incidence of and Demographic Disparities Among Fifth Metatarsal Fracture Nonunions

Aim: This study aimed to assess the incidence and demographics of fifth metatarsal (5MT) fractures, as well as the association of these factors with nonunion rates. Materials and methods: A total of 1,000 adult patients with confirmed 5MT fractures were recruited retrospectively. Patients were scree...

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Main Authors: Alexandra Flaherty, Bardiya Akhbari, Hamid Ghaednia, Soheil Ashkani-Esfahani, Lorena Bejarano-Pineda
Format: Article
Language:English
Published: Jaypee Brothers Medical Publisher 2022-12-01
Series:Journal of Foot and Ankle Surgery (Asia Pacific)
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Online Access:https://www.jfasap.com/doi/JFASAP/pdf/10.5005/jp-journals-10040-1275
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author Alexandra Flaherty
Bardiya Akhbari
Hamid Ghaednia
Soheil Ashkani-Esfahani
Lorena Bejarano-Pineda
author_facet Alexandra Flaherty
Bardiya Akhbari
Hamid Ghaednia
Soheil Ashkani-Esfahani
Lorena Bejarano-Pineda
author_sort Alexandra Flaherty
collection DOAJ
description Aim: This study aimed to assess the incidence and demographics of fifth metatarsal (5MT) fractures, as well as the association of these factors with nonunion rates. Materials and methods: A total of 1,000 adult patients with confirmed 5MT fractures were recruited retrospectively. Patients were screened for union vs nonunion, where nonunion was defined as failure to heal completely within 180 days of fracture diagnosis. Inclusion criteria were: (1) age of ≥ 18-year-old and (2) confirmation of 5MT fracture by experts based on examination and radiograph. Exclusion criteria were: (1) missing data on final healing status, (2) presence of another traumatic injury to the foot during the healing process of the primary 5MT fracture, (3) lack of radiologic proof of healing or nonhealing, and (4) missing demographic data or relevant clinical or operative notes. Data on demographics, fracture characteristics, and treatment methods (conservative vs operative) were also collected. One-way analysis of variance (ANOVA) and Chi-square analysis was used, and <italic>p</italic> < 0.05 was considered statistically significant. Results: The overall nonunion rate was 22.4%, with zone 2 demonstrating the highest nonunion rate (28.1%). Weight and body mass index (BMI) were correlated with a higher nonunion rate (<italic>p</italic> = 0.002 and <italic>p</italic> = 0.012, respectively). Type of treatment (operative vs conservative) and displacement were not correlated with nonunion; however, stratification by both types of treatment and displacement revealed a difference in nonunion between the three fracture zones. Clinical significance: 5MT fracture nonunion remains a prevalent problem. The association between nonunion and weight, BMI, and fracture characteristics can be used by clinicians in the decision-making process regarding treatment and management of 5MT fractures to reduce the incidence of nonunion, improve patient-reported outcomes, and reduce the healthcare burden.
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spelling doaj-art-3f99e1238c2a4201b7bdfa66ed5492682025-08-20T03:18:20ZengJaypee Brothers Medical PublisherJournal of Foot and Ankle Surgery (Asia Pacific)2348-280X2394-77052022-12-0110181210.5005/jp-journals-10040-12753The Incidence of and Demographic Disparities Among Fifth Metatarsal Fracture NonunionsAlexandra Flaherty0https://orcid.org/0000-0003-2474-3119Bardiya Akhbari1Hamid Ghaednia2Soheil Ashkani-Esfahani3https://orcid.org/0000-0003-2299-6278Lorena Bejarano-Pineda4Alexandra Flaherty, Foot & Ankle Research and Innovation Laboratory (FARIL), Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States; John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, United States, Phone: +12102518913FARIL-SORG Collaborative, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United StatesFARIL-SORG Collaborative, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United StatesFoot & Ankle Research and Innovation Laboratory (FARIL), Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States; FARIL-SORG Collaborative, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States; Foot & Ankle Center, Massachusetts General Hospital, Newton-Wellesley Hospital, Boston, Massachusetts, United StatesFoot & Ankle Research and Innovation Laboratory (FARIL), Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States; Foot and Ankle Center, Massachusetts General Hospital, Newton-Wellesley Hospital, Boston, Massachusetts, United StatesAim: This study aimed to assess the incidence and demographics of fifth metatarsal (5MT) fractures, as well as the association of these factors with nonunion rates. Materials and methods: A total of 1,000 adult patients with confirmed 5MT fractures were recruited retrospectively. Patients were screened for union vs nonunion, where nonunion was defined as failure to heal completely within 180 days of fracture diagnosis. Inclusion criteria were: (1) age of ≥ 18-year-old and (2) confirmation of 5MT fracture by experts based on examination and radiograph. Exclusion criteria were: (1) missing data on final healing status, (2) presence of another traumatic injury to the foot during the healing process of the primary 5MT fracture, (3) lack of radiologic proof of healing or nonhealing, and (4) missing demographic data or relevant clinical or operative notes. Data on demographics, fracture characteristics, and treatment methods (conservative vs operative) were also collected. One-way analysis of variance (ANOVA) and Chi-square analysis was used, and <italic>p</italic> < 0.05 was considered statistically significant. Results: The overall nonunion rate was 22.4%, with zone 2 demonstrating the highest nonunion rate (28.1%). Weight and body mass index (BMI) were correlated with a higher nonunion rate (<italic>p</italic> = 0.002 and <italic>p</italic> = 0.012, respectively). Type of treatment (operative vs conservative) and displacement were not correlated with nonunion; however, stratification by both types of treatment and displacement revealed a difference in nonunion between the three fracture zones. Clinical significance: 5MT fracture nonunion remains a prevalent problem. The association between nonunion and weight, BMI, and fracture characteristics can be used by clinicians in the decision-making process regarding treatment and management of 5MT fractures to reduce the incidence of nonunion, improve patient-reported outcomes, and reduce the healthcare burden.https://www.jfasap.com/doi/JFASAP/pdf/10.5005/jp-journals-10040-1275fifth metatarsalmetatarsal fracturenonunion
spellingShingle Alexandra Flaherty
Bardiya Akhbari
Hamid Ghaednia
Soheil Ashkani-Esfahani
Lorena Bejarano-Pineda
The Incidence of and Demographic Disparities Among Fifth Metatarsal Fracture Nonunions
Journal of Foot and Ankle Surgery (Asia Pacific)
fifth metatarsal
metatarsal fracture
nonunion
title The Incidence of and Demographic Disparities Among Fifth Metatarsal Fracture Nonunions
title_full The Incidence of and Demographic Disparities Among Fifth Metatarsal Fracture Nonunions
title_fullStr The Incidence of and Demographic Disparities Among Fifth Metatarsal Fracture Nonunions
title_full_unstemmed The Incidence of and Demographic Disparities Among Fifth Metatarsal Fracture Nonunions
title_short The Incidence of and Demographic Disparities Among Fifth Metatarsal Fracture Nonunions
title_sort incidence of and demographic disparities among fifth metatarsal fracture nonunions
topic fifth metatarsal
metatarsal fracture
nonunion
url https://www.jfasap.com/doi/JFASAP/pdf/10.5005/jp-journals-10040-1275
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