Conservative treatment of refractures after modified tension band wiring of fifth metatarsal base stress fractures in athletes

Objective: Recurrent fifth metatarsal base stress fractures (MT5-BSF) in athletes present a challenging problem. The aim of this study was to evaluate the result of conservative treatment for the refracture of MT5-BSF after modified tension band wiring (MTBW). Materials and Methods: The outcomes of 15 elite athletes undergoing conservative treatment for refracture of MT5-BSF after MTBW were retrospectively reviewed. They were instructed to avoid weight-bearing with short leg cast for 6 weeks. After that, they started partial weight with a postop shoe. Stepwise exercise followed bone union by radiographs. Results: Thirteen cases (86.6%) had a complete bone union after a mean of 18.9 +/- 8.6 weeks. Twelve cases (80%) returned to their previous activity level and maintained for at least two consecutive seasons. Conclusion: Eighty percent of all athletic patients with the conservative treatment for refractures with healed MT5-BSF after MTBW on the plantar-lateral side could maintain and return to their previous sports activity for at least 2 years.