Aims This study evaluated the effect of treating clinician speciality on management of zone 2 fifth metatarsal fractures. Methods This was a retrospective cohort study of patients with acute zone 2 fifth metatarsal fractures who presented to a single large, urban, academic medical centre between December 2012 and April 2022. Zone 2 was the region of the fifth metatarsal base bordered by the fourth and fifth metatarsal articulation on the oblique radiograph. The proportion of patients allowed to bear weight as tolerated immediately after injury was compared between patients treated by orthopaedic surgeons and podiatrists. The effects of unrestricted weightbearing and foot and/or ankle immobilization on clinical healing were assessed. A total of 487 patients with zone 2 fractures were included (mean age 53.5 years (SD 16.9), mean BMI 27.2 kg/m2 (SD 6.0)) with a mean follow-up duration of 2.57 years (SD 2.64). Results Overall, 281 patients (57.7%) were treated by orthopaedic surgeons, and 206 patients (42.3%) by podiatrists. When controlling for age, sex, and time between symptom onset and presentation, the likelihood of undergoing operative treatment was significantly greater when treated by a podiatrist (odds ratio (OR) 2.9 (95% CI 1.2 to 8.2); p = 0.029). A greater proportion of patients treated by orthopaedic surgeons were allowed to immediately bear weight on the injured foot (70.9% (178/251) vs 47.3% (71/150); p < 0.001). Patients treated by podiatrists were immobilized for significantly longer (mean 8.4 weeks (SD 5.7) vs 6.8 weeks (SD 4.3); p = 0.002) and experienced a significantly longer mean time to clinical healing (12.1 (SD 10.6) vs 9.0 weeks (SD 7.3), p = 0.003). Conclusion Although there was considerable heterogeneity among zone 2 fracture management, orthopaedic surgeons were less likely to treat patients operatively and more likely to allow early full weightbearing compared to podiatrists.

中文翻译：

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2 区第五跖骨骨折的治疗因治疗专业而异。


目的 本研究评估了临床医生专业治疗对 2 区第五跖骨骨折治疗的效果。方法 这是一项回顾性队列研究，对象为 2012 年 12 月至 2022 年 4 月期间就诊于单一大型城市学术医疗中心的急性第 2 区第五跖骨骨折患者。第 2 区是第五跖骨基底部与第四跖骨和第四跖骨接壤的区域。斜位X光片上的第五跖骨关节。比较了接受整形外科医生和足病医生治疗的患者在受伤后立即承受体重的患者比例。评估不受限制的负重以及足部和/或踝关节固定对临床愈合的影响。共有 487 名 2 区骨折患者纳入研究（平均年龄 53.5 岁（SD 16.9），平均 BMI 27.2 kg/m2（SD 6.0）），平均随访时间为 2.57 年（SD 2.64）。结果 总体而言，281 名患者（57.7%）接受了骨科医生的治疗，206 名患者（42.3%）接受了足病医生的治疗。当控制年龄、性别以及症状出现和出现之间的时间间隔时，由足病医生治疗时接受手术治疗的可能性显着更大（比值比 (OR) 2.9（95% CI 1.2 至 8.2）；p = 0.029）。在接受整形外科医生治疗的患者中，有较大比例的患者被允许立即用受伤的脚承受重量（70.9% (178/251) vs 47.3% (71/150)；p < 0.001）。接受足病医生治疗的患者的固定时间明显更长（平均 8.4 周 (SD 5.7) 对比 6.8 周 (SD 4.3)；p = 0.002），并且平均临床愈合时间明显更长（12.1 (SD 10.6) 对比 9.0 周 (SD 4.3)） 7.3），p = 0.003）。 结论 尽管 2 区骨折治疗存在相当大的异质性，但与足病医生相比，骨科医生不太可能对患者进行手术治疗，并且更有可能允许早期完全负重。