Conservative Treatment Versus Herbert Screw Fixation for Acute Zone-II (Jones) Fractures of the Fifth Metatarsal: Prospective Comparative Study

Vollständiger Abstract

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Background: Acute Zone-II fractures of the proximal fifth metatarsal (Jones fractures) occur at a region with relatively limited vascularity and are associated with delayed union, non-union and prolonged functional recovery. Conservative immobilization remains an accepted option in selected patients, whereas intramedullary fixation is often preferred when early stability and mobilization are important. Headless compression implants, including the Herbert screw, provide interfragmentary compression without a prominent screw head. Objective: To compare functional recovery, pain, radiological union and complications following conservative treatment versus Herbert screw fixation in acute Zone-II Jones fractures. Methods: This studywas conducted as a prospective comparative study of 16 adults, with 8 treated conservatively and 8 treated with a headless double-threaded Herbert screw. Follow-up was done at 2, 4, 6 and 12 weeks and 6 months. Functional outcome was assessed using the AOFAS score, pain using VAS, and union using serial radiographs. Continuous outcomes were compared with Welch's t-test and categorical outcomes with Fisher's exact test. Results: In this study, mean AOFAS scores were higher with Herbert screw fixation at 6 weeks (78.8 ± 5.3 vs 66.8 ± 4.3; p