Fifth metatarsal tuberosity avulsion fractures: a new surgical technique without metal implant

Background: Lawrence and Botte classified in the 1993 the fractures of 5MTB in a Zone 1 (tuberosity avulsion fracture), Zone 2 (Jones fracture), and Zone 3 (stress diaphyseal fractures). Despite good outcomes with non-operative treatment, displacement, intra-articular involvement, comminution or painful non-union of Zone 1 fracture have been reported to benefit with early open reduction and fixation. We considered a Zone 1 fracture (tuberosity avulsion) with displacement of the segment from the metatarsal metaphysis > 2 mm. Surgical technique: We describe a surgical procedure for the tuberosity avulsion fractures (Zone 1 of Lawrence and Botte classification or type I-B of Mehlhorn classification) using FiberWire or Vycril sutures. Conclusions: This technique, without using metal implant, provides a theoretically lower rate of infections, could be useful in patients referring metal allergy or hypersensitivity to metal implants and it is not necessary the fluoroscopic guidance.