Essential Insights On Treating Fifth Metatarsal Fractures

By Nicholas Romansky, DPM, and Todd Becker, DPM


CE Exam #140 Choose the single best response to each question listed below. 1. What procedure is generally indicated for a non-reducible fracture and residual displacement of 3 to 4 mm or a sagittal plane with an angulation of 10 degrees? a) External fixation b) Arthroplasty c) Open reduction with internal fixation (ORIF) d) None of the above 2. When treating most flexural transverse fractures and buckling impaction fractures of the fifth metatarsal, how long should one utilize cast immobilization? a) Two to three weeks b) Four to six weeks c) Four to eight weeks d) Six to eight weeks 3. Spiral fractures … a) are the most common neck fracture of the fifth metatarsal b) may require metatarsal head resection with conversion into an arthroplasty if one cannot reconstruct the articular surface c) tend to be displaced plantarly along the shearing axis of the fracture d) all of the above 4. Capital fractures due to compression … a) tend to involve significant displacement b) are frequently caused by the demi pointe position related to dancing c) tend to be quite stable and only involve minor displacement d) a and b 5. Which type of Jones fracture is common in runners or soccer players? a) Cervical fractures b) Capital fractures c) Proximal diaphyseal stress fractures d) Metaphyseal-diaphyseal fractures 6. Husain and DeFronzo found less resistance to load failure with … a) bicortical screw fixation b) ORIF c) percutaneous pinning d) intramedullary screw fixation 7. In a tuberosity fracture, joint displacement of more than __ is one indication for ORIF with intramedullary screws, tension band wiring or fragment excision with tendon repair. a) 2.5 mm b) 3 mm c) 4 mm d) 5 mm 8. Proximal fifth metatarsal fractures typically demonstrate … a) severe displacement b) minimal displacement and heal well with four weeks of orthotic use c) minimal displacement and heal well with two weeks of a short leg cast and a progressive return to shoe gear d) severe displacement that can only be corrected with ORIF 9. According to Stewart’s classification, a Type III tuberosity fracture is … a) an extraarticular fracture of the styloid process b) an intraarticular fracture of the base of the metatarsal c) an intraarticular comminuted fracture of the metatarsal base d) an extraarticular fracture of the base of the metatarsal 10. Which of the following provides 30 percent of the blood supply to the bone of the fifth metatarsal? a) The network of arteries to the fifth metatarsal b) The plantar branch of the nutrient artery c) The joint interface d) The periosteum Instructions for Submitting Exams Fill out the enclosed card that appears on the following page or fax the form to NACCME at (610) 560-0502. Within 60 days, you will be advised that you have passed or failed the exam. A score of 70 percent or above will comprise a passing grade. A certificate will be awarded to participants who successfully complete the exam. Responses will be accepted up to 12 months from the publication date.


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