Distal ulna locking compression hook plate used as an alternative fixation for the fifth metatarsal base fracture

Objective To evaluate the surgical treatment of the fifth metatarsal base fracture using distal ulna locking compression hook plate (DULCHP).Methods From October 2011 to November 2012,17 patients with fracture of the fifth metatarsal base were treated with open reduction and internal fixation with DULCHP.They were 6 men and 11 women,aged from 22 to 72 years (mean,35.8 years).According to the Lawrence and Botte classification of anatomic zones,14 cases had fracture in zone Ⅰ and 3 in zone Ⅱ.An initial fracture displacement more than 2 mm and significant disruption of the cuboid-fifth metatarsal joint were involved in the avulsion fractures.Results Fifteen patients were followed up for an average of 28 weeks (range,from 24 to 64 weeks).No infection,screw breakage or reduction loss occurred in this series postoperatively.The mean time to complete union as determined by X-ray ranged from 70 to 118 days (mean,84 days).By the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scale,the therapeutic efficacy scored 87.4 points on average (range,76 to 91 points).All patients reported returning to prior activities of daily living at a mean time of 104 days (range,91 to 137 days).Conclusion DULCHP fixation is an effective alternative surgical method for displaced fractures of the fifth metatarsal base at zones Ⅰ and Ⅱ,because its mini-hook tubular plate is so designed that the last hole can function as a hook for applying compression force,grasping comminuted fragments,and maintaining rotational stabilization of the metatarsal base fracture. Key words: Metatarsal bones;  Fracture, bone;  Fracture fixature, internal;  Bone plate