Meta-analysis Of Surgical And Conservative Treatment Of Basal Fracture Of The Fifth Metatarsal Bone

Objective:To compare the clinical effect of surgical and conservative treatment of the fifth metatarsal base fracture.Methods:Pub Med Central,Cochrane Library,Embase,CNKI,Wanfang Medical Network and other databases were used to search literatures on the clinical efficacy comparison between operative and conservative teratment of fifth metatarsal basal fracture from January 2001 to December 2020.The Rev Man 5.3 software provided by the Cochrane International Collaboration was used for comparing the fifth metatarsal basement fractures treated by operative and conservative treatment in the rate of non-union,fracture healing time,postoperative complications,the American association of ankle foot before scoring criteria(AOFAS),visual analogue scale score(VAS),average of time return to a normal life and activity differences.Results:(1)A total of 417 patients were included in 11 studies.(2)The results indicated that there were significant differences between operative and conservative treatment thefifth metatarsal base fracture inthe rate of non-union(OR=6.83,95%CI: 2.83—1.52,P <0.0001),[the delayed healing rate(OR=0.14,95%CI: 0.04—0.49,P=0.002),fracture malunion rate(OR=0.12,95%CI: 0.03—0.48,P=0.003)],fracture healing time(MD=-3.00,95%CI:-3.77—-1.65,P < 0.00001),AOFAS(MD=2.00,95%CI: 0.65—3.36,P=0.004),VAS(MD=-0.18,95%CI:-0.29—-0.06,P=0.002),and mean time to return to normal life and activity(MD=-3.55,95%CI:-6.04—-1.05,P=0.005)of the fifth metatarsal base fracture in the operative group were higher than those in the conservative group.However,there was no significant difference in the rate of fracture union(OR=4.11,95%CI:0.44--38.73,P = 0.22)OR the rate of delayed fracture union(OR=0.09,95%CI:0.01--1.08,P = 0.06)between surgery and conservative treatment for zone 1 fracture at the base of the fifth metatarsal.Conclusion:Surgical treatment can be used as the first choice for the fracture of the second region of the fifth metatarsal base.For zone 1 fracture,conservative treatment has some advantages,but the high rate of fracture malunion should be paid attention to by the operator.