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Retrospective Observational Study

COMPARATIVE OUTCOMES OF EARLY VERSUS DELAYED WEIGHT-BEARING IN FIFTH METATARSAL BASE FRACTURES: A RETROSPECTIVE STUDY

F. Pezone1 ORCID, G. D'Andrea2, M. Alessio-Mazzola1 ORCID, G. Placella2, S. Mosca2 ORCID, V. Salini2

1 IRCCS San Raffaele Hospital, Milan, Italy
2 Vita-Salute University, IRCCS San Raffaele Hospital, Milan, Italy

Correspondence to:

Mattia Alessio Mazzola, MD
IRCCS San Raffaele Hospital,
Clinical Unit of Orthopedics and Traumatology,
Via Olgettina 60,
Milano, Italy

Journal of Orthopedics 2022 May-Aug; 14(2): 57-62


Received: 29 June 2022 Accepted: 14 August 2022

Copyright © by LAB srl 2022 ISSN 1973-6401 (print) / 3035-2916 (online)
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Abstract

Fractures of the fifth metatarsal base are common foot injuries, especially in athletes and active individuals. Treatment strategies vary between early and delayed weight-bearing, but limited evidence exists on which approach leads to better clinical and functional outcomes. This retrospective, single-center study compares the effects of early versus delayed weight-bearing on clinical and functional recovery in patients with fifth metatarsal base fractures between January 1, 2020, and December 31, 2021. Data from 40 patients treated at a single center for fifth metatarsal base fractures were analyzed. Patients were divided into two groups according to treatment decision: 20 in the early weight-bearing group (within 2 weeks post-injury) and 20 in the delayed weight-bearing group (after 4-6 weeks of immobilization). Clinical and functional outcomes, including return to activity, pain levels measured with Visual Analogue Scale (VAS), Foot and Ankle Disability Index (FADI), satisfaction rates, and complications, were assessed and compared at 6 months follow-up. The study included 14 male and 26 female patients, with a mean age of 43.5 ± 15.5 years. No significant difference in subjective satisfaction and FADI score was found between early and delayed weight-bearing at the final follow-up assessment (p>0.05). However, a significantly earlier return to sports and physical activity was observed in the early weight-bearing group (p<0.001). In conclusion, early weight-bearing in fifth metatarsal base fractures allows for an earlier return to activity without compromising patient satisfaction or increasing complications. These findings support early weight-bearing as a viable option for promoting faster recovery in appropriately selected patients without compromising clinical outcomes.

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