Elite athletes can often incur proximal fractures of the fifth metatarsal (zone II and III). These injuries can be difficult to treat because of a tendency toward delayed union, nonunion or refracture. Researchers reviewed 10 NBA players’ records, seven of whom underwent standard percutaneous internal fixation with bone marrow aspirate concentrate (BMAC) and three of whom had open bone grafting in addition to fixation and BMAC. Three athletes experienced refractures, and the average time for return to play was 9.8 weeks. No significant difference was found in clinical features or radiographic measurements. Researchers found that these large players had a unique foot type associated with increased fracture and refracture of the fifth metatarsal. While the standard internal fixation method is still viable, the additional bone grafting can still be used to improve fracture healing and potentially decrease risk of refracture.
Foot & Ankle International (01/16) O’Malley, Martin; DeSandis, Bridget; Allen, Answorth; et al.