Measurement of the results of functional treatment of metatarsal fractures using the AOFAS scale and the duration of work incapacity

OBJECTIVETo demonstrate the effectiveness of functional treatment for the fractures of the metatarsal, which consisted of immediate or early weight bearing without immobilisation.MATERIAL AND METHODOLOGYWe prospectively studied 276 patients with simple or complex fractures of the metatarsal, treated with a functional method which consisted of immediate (before the 3(rd) day since the fracture) or early (between 3(rd) and 21(st) day) effective weight bearing. Inclusion criteria were patients aged 16-65, both sexes, diagnosed with isolated or multiple, closed or opened type I metatarsal fractures who did weight bearing exercises during the first 21 days. We analysed the effects of the steroid injection proposed for this treatment in the focus of the fracture, the days of weight bearing, rehabilitation and number of metatarsal fractures. Results were evaluated using AOFAS (American Orthopaedic Foot and Ankle Society) scores, days of work incapacity and complications of the treatment.RESULTSThe AOFAS score for patients treated functionally was excellent and we found few complications with it.DISCUSSIONThe functional method is based on the function of ligaments and muscles of the forefoot and the aid of a rigid-soled shoe which allows early weight-bearing to avoid secondary displacement of the fractures. The results show that immediate weight bearing provides better results than delayed bearing. Injection of steroid does not appear to have any benefit.CONCLUSIONSWe propose the functional method for all closed displaced or non-displaced metatarsal fractures, except for the displaced fractures on the base of the fifth metatarsal.