{
    "abstract": "Minimally invasive stabilization of metatarsal fractures to enable adequate fracture healing in a\u00a0correct position to restore anatomy and biomechanics of the foot.\nA.\u00a0Dislocated diaphyseal and subcapital fractures of the second to fifth metatarsal (>\u202f3\u202fmm, >\u202f10\u00b0 dislocation). B.\u00a0Fifth metatarsal fracture at the metadiaphyseal junction (Lawrence and Botte type\u00a0III).\nHigh grade soft tissue damage or infection at the implant insertion site.\nA.\u00a0Fluoroscopically assisted closed reduction and antegrade intramedullary fixation of diaphyseal and subcapital fractures of the second to fifth metatarsal. B.\u00a0Fluoroscopically assisted wire-guided intramedullary screw fixation of fifth metatarsal fractures at the metadiaphyseal junction.\nA.\u00a0Mobilization with partial weight bearing (20\u202fkg) for 6\u00a0weeks wearing a\u00a0stiff sole; implant removal under local anesthesia after 6-8\u00a0weeks, followed by a\u00a0free range of movement and weight-bearing as tolerated (WBAT). B.\u00a0Early mobilization with weight-bearing as tolerated (WBAT); removal of the orthosis after 6\u00a0weeks, implant removal optional.\nA.\u00a0Antegrade nailing of subcapital and shaft fractures of metatarsals\u00a0II-V achieves good clinical results with low complication rates both when using prepared Kirschner wires or elastically stable intramedullary nails (ESIN). B.\u00a0According to current literature, intramedullary screw osteosynthesis of proximal metatarsal\u00a0V fractures of zone\u00a0II and\u00a0III according to Lawrence and Botte leads to faster bony healing with a\u00a0lower nonunion rate compared with conservative treatment. It is recommended especially, but not only, for active athletes.\nOPERATIONSZIEL: Minimal-invasive Stabilisierung von Mittelfu\u00dffrakturen zur Erm\u00f6glichung einer sicheren kn\u00f6chernen Heilung in korrekter Stellung zur Wiederherstellung der Anatomie und Biomechanik des Fu\u00dfes.\nA.\u00a0Dislozierte diaphys\u00e4re und subkapitale Metatarsale(MT)-II- bis -V-Frakturen (>\u202f3\u202fmm, >\u202f10\u00b0 Achsdislokation). B.\u00a0MT-5-Frakturen am metadiaphys\u00e4ren \u00dcbergang (Lawrence und Botte Typ\u00a0III).\nH\u00f6hergradiger Weichteilschaden oder Infektion an der Insertionsstelle der Implantate.\nA.\u00a0Bildwandlergest\u00fctzte geschlossene Reposition und antegrade intramedull\u00e4re Schienung von diaphys\u00e4ren und subkapitalen Metatarsale-II- bis -V-Frakturen. B.\u00a0Bildwandlergest\u00fctzte drahtgef\u00fchrte intramedull\u00e4re Schraubenosteosynthese von Metatarsale-V-Frakturen am metadiaphys\u00e4ren \u00dcbergang.\nA.\u00a0Bei fester Sohle Mobilisation unter 20\u202fkg Teilbelastung f\u00fcr 6\u00a0Wochen; Implantatentfernung in Lokalan\u00e4sthesie nach 6 bis 8\u00a0Wochen, danach Bewegungs- und Belastungsfreigabe. B.\u00a0Bei fester Sohle z\u00fcgige Mobilisation unter schmerzadaptierter Belastung anstreben; nach 6\u00a0Wochen Entfernung der Orthese, Implantatentfernung fakultativ.\nA.\u00a0Die antegrade Schienung subkapitaler und Schaftfrakturen von Metatarsale\u00a0II\u2013V f\u00fchrt sowohl bei Verwendung von pr\u00e4parierten Kirschner-Dr\u00e4hten als auch beim Einsatz von elastisch-stabilen intramedull\u00e4ren N\u00e4geln (ESIN) zu guten klinischen Ergebnissen bei geringen Komplikationsraten. B.\u00a0Die intramedull\u00e4re Schraubenosteosynthese von basalen Metatarsale-V-Frakturen der Zone\u00a0II und\u00a0III nach Lawrence und Botte f\u00fchrt im Vergleich zur konservativen Therapie nach aktueller Literaturlage zu einer schnelleren kn\u00f6chernen Heilung bei geringerer Pseudarthroserate. Sie wird insbesondere, aber nicht nur bei aktiven Sportlern empfohlen.",
    "authors": [
        {
            "affiliation": "Klinik f\u00fcr Unfall\u2011, Hand- und Wiederherstellungschirurgie, Universit\u00e4tsmedizin Rostock, Schillingallee\u00a035, 18057, Rostock, Deutschland. patrick.gahr@med.uni-rostock.de.",
            "firstname": "Patrick",
            "initials": "P",
            "lastname": "Gahr"
        },
        {
            "affiliation": "Klinik f\u00fcr Unfall\u2011, Hand- und Wiederherstellungschirurgie, Universit\u00e4tsmedizin Rostock, Schillingallee\u00a035, 18057, Rostock, Deutschland.",
            "firstname": "Lennart",
            "initials": "L",
            "lastname": "Schleese"
        },
        {
            "affiliation": "Klinik f\u00fcr Unfall\u2011, Hand- und Wiederherstellungschirurgie, Universit\u00e4tsmedizin Rostock, Schillingallee\u00a035, 18057, Rostock, Deutschland.",
            "firstname": "Thomas",
            "initials": "T",
            "lastname": "Mittlmeier"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.\n\u00a9 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.",
    "doi": "10.1007/s00064-024-00853-x\n10.2106/00004623-197860060-00008\n10.1016/j.injury.2004.07.015\n10.1007/s00064-021-00750-7\n10.1177/107110079301400610\n10.1016/j.injury.2012.03.010\n10.1007/s00113-018-0507-6\n10.1007/s00113-008-1508-7\n10.1177/0363546510393306\n10.1177/0363546504272262\n10.1053/j.jfas.2014.11.010\n10.5312/wjo.v13.i4.408\n10.1177/1938640015592836\n10.1053/j.jfas.2021.12.025\n10.1177/1071100720947411\n10.1177/107110079902000308\n10.1053/j.jfas.2023.05.005",
    "journal": "Operative Orthopadie und Traumatologie",
    "keywords": [
        "Antegrade intramedullary fixation",
        "Biomechanics",
        "Intramedullary screw osteosynthesis",
        "Metatarsal fractures",
        "Toe fractures"
    ],
    "methods": null,
    "publication_date": "2024-07-29",
    "pubmed_id": "39073454\n701310\n15315883\n34811573\n8406253\n22465516\n29777283\n18820890\n26670302\n21212308\n34789369\n2186093\n15888715\n25624041\n35582152\n26130624\n35016832\n32795095\n10195297\n37211269",
    "results": "A.\u00a0Antegrade nailing of subcapital and shaft fractures of metatarsals\u00a0II-V achieves good clinical results with low complication rates both when using prepared Kirschner wires or elastically stable intramedullary nails (ESIN). B.\u00a0According to current literature, intramedullary screw osteosynthesis of proximal metatarsal\u00a0V fractures of zone\u00a0II and\u00a0III according to Lawrence and Botte leads to faster bony healing with a\u00a0lower nonunion rate compared with conservative treatment. It is recommended especially, but not only, for active athletes.",
    "title": "[Surgical treatment of forefoot and midfoot fractures : Minimally invasive fixation of metatarsal fractures].",
    "xml": "<Element 'PubmedArticle' at 0x788503f8e480>"
}