Concluded Case

ORTHOPEDIC

DISCUSS TREATMENT PLAN FOR # of 5th METATARSAL BONE OF FEET!

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I have treated few of these fractures with pop Six weeks pop and non weight bearing After that pop removal: crepe bandage and graduated weight bearing with Walker or so. Another month full weight bearing with support What I observed is fracture become painless in six weeks Xray will show gap Another month you can see gap filing up with bridging callus In six months it get filled up completely By 3months time patient can be back on his feet Another option is anatomical reduction and k wires which can be removed at 6 weeks Radiological union will be faster Both methods are equally successful

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1. Difficult (due to strong flexors and bulky musculatures of thighs) 2. Not advisable (risk of compression or rupture of the local artery, while manipulating for reduction) 3. Healing rate is much slower 4. Chances of Mal-Union (strong musculature) 5. Chances of Shortening of length of reduced limb. 6. Risks of frequent local infections (due to high vascularity of the surrounding area). Hence Open reduction thru surgery is the best VIABLE OPTION in such cases. Traditionally practicing physicians in certain areas of Puttur district of A.P., do follow the principles of Ayurveda in such cases with closed reduction. They use their secret herbs (probably the asthi sandhanakara herbs) after reducing the fractured site and use finely chivelled Bamboo sticks to hold the reduced bones in place followed by Bandhana with clothes. May be we could learn from them., if we shed our egos and be a disciple to them in assisting them in their work. They get exposed to more number of complicated fractures. Based on the sadhya asadhyata learnt from their experience they accept or decline such complicated cases. (Most challenging they do accept). Sorry for giving up a mixed reaction to your question, but I thought better to give the input of pros & cons related to the topic

Np thanks for your reply and inputs.
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I have treated few of these fractures with pop Six weeks pop and non weight bearing After that pop removal: crepe bandage and graduated weight bearing with Walker or so. Another month full weight bearing with support What I observed is fracture become painless in six weeks Xray will show gap Another month you can see gap filing up with bridging callus In six months it get filled up completely By 3months time patient can be back on his feet Another option is anatomical reduction and k wires which can be removed at 6 weeks Radiological union will be faster Both methods are equally successful

Displaced spiral fracture of the 5th metatarsal. Orif needed with immobilisation & non weight bearing on RT foot, post fixation for 6 weeks. NSAID'S n Elevation.

Displaced fracture of 5 th Metatarsal bone fracture reduction & fixation If Fracture fregment involves 30 percent cubometatarsal joint

IMMOBILIZATION.. WITH.. EXPERTS OPINION.. NSAIDS.. ANTIBIOTICS.. SOS.. CALCIUM. VITAMIN D.. AVOID EXPOSURE TO PRSSURE..

Sir! The plaster has been done with no recovery since one month.
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maintaining of height is required in this fracture needs orif with mini fragment plating

Apparently displaced fracture requires K -wire fixation of 5th metacarpal fracture

Thanks Dr. Kute Ankush,Dr. A Dutta
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Open reduction with k-wire fixation of 5th metacarpel #

Sir, metatarsal bone.
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Need for fixation should refer to orthopedic surgeon

Refer to orthopedic surgeon for fixation .

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