The Biology of Bone and Ligament Healing

Multiple factors, such as genetic predisposition, comorbidities, anatomy, proper and prompt diagnosis, treatment type (conservative or surgical), and patient compliance, all contribute to the challenges associated with effectively treating fifth metatarsal injury, CN, and arthrodesis. Even though these conditions have been extensively studied, successfully healing these conditions is still difficult. Research suggests that effective treatment begins with rapid and accurate diagnosis of the condition, which is best completed using advancing imaging, such as MRI. The stage of the condition, patient risk factors, and comorbidities dictate whether conservative treatment or surgical intervention is necessary. Conservative treatment often leads to refracture, nonunion, or secondary complications like ulceration or infection. Failed conservative treatment eventually leads to surgical intervention. Surgical intervention can include internal fixation, external fixation, bone grafts, orthobiologics, adjuvants, or a combination of these methods, each of which has its drawbacks, including pin migration, heterotopic ossification, or hardware failure. Despite these disadvantages, conservative and surgical treatment can be successful. Additional randomized controlled trials, however, applying new or improved methods needs to be conducted to justify their use on BLT-related injuries in the future.