@article{Samaila_Ditta_Negri_Leigheb_Colò_Magnan_2020, title={Central metatarsal fractures: a review and current concepts}, volume={91}, url={https://mattioli1885journals.com/index.php/actabiomedica/article/view/9724}, DOI={10.23750/abm.v91i4-S.9724}, abstractNote={<p class="p2">Cent<span class="s1">r</span>al metatarsal f<span class="s1">r</span>actu<span class="s4">r</span>es (CMF) a<span class="s4">r</span>e c<span class="s4">o</span>mm<span class="s4">o</span>n inju<span class="s1">r</span>ies. Mo<span class="s4">r</span>e f<span class="s4">r</span>equent<span class="s1">l</span>y f<span class="s1">r</span>actu<span class="s4">r</span>es a<span class="s4">r</span>e those of the fi<span class="s2">f</span>th metatarsal, fo<span class="s1">l</span>l<span class="s4">o</span>wed by CMF and the<span class="s4">r</span>efo<span class="s4">r</span>e by the first metatarsal. Thi<span class="s4">r</span>d metatarsal is inju<span class="s4">r</span>ed most f<span class="s4">r</span>equent<span class="s1">l</span>y than the others and up to 63% is associated with sec<span class="s4">o</span>nd or fou<span class="s1">r</span>th metatarsal f<span class="s1">r</span>actu<span class="s4">r</span>es and up to 28% with both. <span class="s4">A</span>nat<span class="s4">o</span>my and metatarsal kinematics me<span class="s1">r</span>its attenti<span class="s4">o</span>n due to its influence <span class="s4">o</span>n functi<span class="s4">o</span>n, inju<span class="s1">r</span>ies and t<span class="s4">r</span>eatment opti<span class="s4">o</span>ns. Diagnosis is based <span class="s4">o</span>n the histo<span class="s5">r</span>y of t<span class="s1">r</span>auma and <span class="s2">c</span>lini<span class="s1">c</span>al examinati<span class="s4">o</span>n, <span class="s4">r</span>elating with inst<span class="s1">r</span>umental exams. <span class="s8">F</span><span class="s1">r</span>actu<span class="s4">r</span>es with less than 10° of angulati<span class="s4">o</span>n and 3-4 mm of t<span class="s1">r</span>anslati<span class="s4">o</span>n in a<span class="s4">n</span>y plane a<span class="s4">r</span>e <span class="s1">ty</span>pi<span class="s1">c</span>a<span class="s1">ll</span>y t<span class="s4">r</span>eated c<span class="s4">o</span>nse<span class="s10">r</span>vati<span class="s1">v</span>e<span class="s1">l</span><span class="s11">y</span>, while ope<span class="s1">r</span>ati<span class="s1">v</span>e t<span class="s4">r</span>eatment is gene<span class="s1">r</span>a<span class="s1">ll</span>y <span class="s4">r</span>ese<span class="s10">r</span><span class="s1">v</span>ed for f<span class="s1">r</span>actu<span class="s4">r</span>es out if these values. Int<span class="s1">r</span>amedu<span class="s1">l</span>la<span class="s5">r</span>y fixati<span class="s4">o</span>n with K-wi<span class="s4">r</span>es seem to be the most c<span class="s4">o</span>mm<span class="s4">o</span>n and valid surgi<span class="s1">c</span>al t<span class="s4">r</span>eatment in simple f<span class="s1">r</span>actu<span class="s4">r</span>es. <span class="s1">S</span>pi<span class="s1">r</span>al f<span class="s1">r</span>actu<span class="s4">r</span>es should be t<span class="s4">r</span>eated by inte<span class="s1">r</span>f<span class="s1">r</span>agmenta<span class="s5">r</span>y sc<span class="s4">r</span><span class="s1">e</span>ws, whi<span class="s1">c</span>h positi<span class="s4">o</span>ning m<span class="s4">a</span>y <span class="s4">r</span>esult difficult due to the adjacent metatarsals. The<span class="s4">r</span>efo<span class="s4">re</span>, an alte<span class="s1">r</span>nati<span class="s1">v</span>e app<span class="s4">r</span>oa<span class="s1">c</span>h is an osteos<span class="s1">y</span>nthesis with a dorsal plate. Multiple metatarsal f<span class="s1">r</span>actu<span class="s4">r</span>es o<span class="s2">f</span>ten occur in the c<span class="s4">o</span>ntiguous b<span class="s4">o</span>nes, so <span class="s2">c</span>linicians wi<span class="s1">l</span>l also ha<span class="s1">v</span>e to <span class="s1">c</span>a<span class="s4">r</span>efu<span class="s1">ll</span>y inspect metatarsals and adjacent joints su<span class="s1">c</span>h as Lisf<span class="s1">r</span>anc a<span class="s1">r</span>ticulati<span class="s4">o</span>n. The <span class="s2">c</span>lini<span class="s1">c</span>al and functi<span class="s4">o</span>nal outc<span class="s4">o</span>mes a<span class="s4">r</span>e o<span class="s2">f</span>ten influenced by the patte<span class="s1">r</span>n of f<span class="s1">r</span>actu<span class="s4">r</span>es and patient c<span class="s4">o</span>nditi<span class="s4">o</span>ns and a<span class="s4">r</span>e <span class="s4">r</span>epo<span class="s1">r</span>ted in the lite<span class="s1">r</span>atu<span class="s4">r</span>e up to 39% of poor <span class="s4">r</span>esults. </p>}, number={4-S}, journal={Acta Biomedica Atenei Parmensis}, author={Samaila, Elena Manuela and Ditta, Alessandro and Negri, Stefano and Leigheb, Massimiliano and Colò, Gabriele and Magnan, Bruno}, year={2020}, month={May}, pages={36–46} }