Non-union in a neck of fifth metatarsal fracture: A case rep
Published in the journal Trauma Case Reports, the authors present the case of a 27-year-old woman who sustained a neck of 5th metatarsal fracture leading to non-union, which was treated successfully with debridement, autologous bone graft and recombinant human platelet-derived growth factor (rhPDGF) and beta-tricalcium phosphate (BTP) granules, combined with internal fixation.

A 27-year-old female presented 8 weeks after sustaining a transverse fracture to the neck of the 5th metatarsal of her left foot. This occurred after an inversion injury of the hindfoot whilst dancing. The patient was a fit and healthy non-smoker with no previous history of injury to this foot.

Management of the fracture at that point had been non-weight-bearing in a stiff-soled postoperative shoe and crutches for 1 week, followed by full-weight-bearing thereafter. At this first visit (8 weeks post injury) the patient reported considerable foot pain and had difficulty mobilising. On examination there was significant tenderness to palpation directly over the fracture site.

Radiographs performed 2 weeks prior to this presentation demonstrated a clear fracture line with minimal evidence of healing. She was transferred into a fracture boot to better stabilise the fracture, however, on follow up 5 weeks after this appointment, now 13 weeks post injury, she described persistent pain with clear evidence of non-union on plain radiographs and CT scan. With clear evidence of a symptomatic, established non-union, the patient was consented for surgery.

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