Jones prijelom pete metatarzalne kosti

master's thesis

• Title (english): Jones fracture of fifth metatarsal bone
• Author: Valentino Zlodi
• Mentor: Božidar Šebečić (mentor)
• Committee member: Mario Starešinić (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Božidar Šebečić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2014-05-30, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Prijelomi pete metatarzalne kosti češće nastaju kod osoba koje su sportski aktivne.
Peta metatarzalna kost se sastoji od baze, tuberositasa, tijela, vrata i glave. Baza
pete metatarzalne kosti je položena proksimalnije od ostalih metatarzalnih kostiju i
zbog toga je kod optrećenja stopala izložena većem naprezanju od ostalih
metatarzalnih kostiju. Prijelomi u ovome području očituju se bolom, oteklinom,
osjetljivošću a dijagnoza se postavlja na temelju kliničkog pregleda i RTG
nalaza.Prema Lawrence i Botte, prijelomi proksimalnog dijela pete metatarzalne kosti
dijele se na avulzijske prijelome, Jones prijelom te stres prijelome. Avulzijski prijelomi
čine najveći udio, nastaju na mjestu tuberositasa za koji se hvata tetiva m. peroneus
brevis te plantarna aponeuroza. Njihova napetost tijekom nagle inverzije pri čemu je
stopalo u plantarnoj fleksiji dovodi do otkinuća i pomaka dijela kosti. Jonesov
prijelom nastaje u području proksimalne metafize i zahvaća zglob između četvrte i
pete metatarzalne kosti. Ozljeda nastaje djelovanjem sile na vanjski dio stopala pri
čemu je peta u kontaktu sa podlogom. Stres prijelomi nastaju na spoju metafize i
dijafize te u proksimalnoj dijafizi, a često su posljedica opetovanih mikrotrauma. Torgova
klasifikacija dijeli Jones i stres prijelome na tri tipa koji se međusobno razlikuju
izgledom na RTG-u, a ujedno se prema toj podijeli i liječe. Tip 1 predstavljaju akutne
prijelome i većinom se liječe konzervativno, imobilizacijom bez opterećenja noge
kroz 6-8 tjedana, za stres prijelome do 20 tjedana. Tip 2 su subakutni prijelomi
(delayed union) liječe se konzervativno ili kirurško liječenje, pri čemu je kirurški izbor
rezerviran za profesionalne sportaše. U Tip 3 spadaju kronični prijelomi
(pseudoartroze) a liječenje je isključivo kirurško, osteosinteza intramedularnim
vijkom.

Abstract (english)

Fractures of fifth metatarsal bone are most common to happen to sports active
people. Structure of fifth metatarsal bone is made of base, tuberosity, body, neck and
head. Avulsion fractures make the most part of the fractures and it appears on the
spot called tuberosity on which is held tendon m. peroneus brevis with plantar
aponeurosis. Their tension during sudden inversion in which the foot is in plantar
flexion leads to separation and the dislocation of part of the bone. Jones fracture
appears disal to the junction of the proximal metaphyseal and diaphyseal, and often
affects the joint between the fourth and fifth metatarsal bones. The injury occurs by
force acting on outer part of the foot, whereby heal is in a contact with a surface. Torg
classification divides Jones and stress fractures into three types which mutually differ
by appearance on RTG (X-ray) and also by that classification they are being
threated. Type 1 requires a conservative approach by immobilization without
burdening a lag through 6-8 weeks and for stress fractures through 20 weeks. Type 2
reguires a conservative or surgical treatment, wherein choice of surgery is reserved
for proffesional athletes. Type 3 is entirely surgical approach and that is
osteosynthesis by intramedullary screw. Stress fractures occur in the proximal
diaphysis and are often the result of repeated microtrauma. The treatment is the
same for Jones fractures. Symptomatic fractures in this area are manifested in pain,
swelling and sensitivity and diagnosis is based on clinical examination and RTG (Xray)
findings.

• Keywords: avulzijski prijelom; Jones prijelom; stres prijelom
• Keywords (english): avulsion fracture; Jones fracture; stress fracture
• Language: croatian
• URN:NBN: urn:nbn:hr:105:494997
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Access restricted to students and staff of home institution
• Created on: 2015-12-16 10:24:49