The purpose of this study was to evaluate the effectiveness of surgical management for acute Jones' fractures and Torg types I and II proximal diaphyseal stress fractures presenting acutely in both athletes and nonathletes. Twenty-two patients underwent intramedullary screw fixation between 1994 and 1999. Immediate intramedullary screw fixation of acute Jones' fractures and type I stress fractures resulted in a 100% union rate with an average time to union of 6.2 weeks. Fixation of type II stress fractures had a union rate of 100% with a mean time to union of 8.3 weeks. The overall complication rate was 9%. Surgical intervention allowed an earlier return to weight-bearing with a more rapid and predictable union rate. The authors recommend intramedullary fixation as a treatment of choice for the management of fifth metatarsal fractures distal to the tuberosity in nonathletes as well as athletes.
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