Iranian Journal of Orthopedic Surgery

Comparing the Outcomes of Nonoperative Treatment of Forefoot Fractures with Casting or

Authors

Ali Akbar Esmailiejah, MD طEsmailiejah, MD
Ali Akbar Esmailiejah, MD طEsmailiejah, MD
Manoochehr Vahid Farahmandi, MD
Mohammadreza Abbasian, MD
Ali Moazamipour, MD
Farshad Safdari, MSc
https://doi.org/10.22034/ijos.2020.121277
Abstract
Background: Forefoot fractures are the most common orthopaedic injuries. In this study the outcomes of nonoperative treatment of forefoot fractures using off-loading shoes was studied and compared with those of casting.Methods: In this case-control study, 60 patients with forefoot fractures in two hospitals in Tehran, Iran, who were not surgical candidates, were divided into two treatment groups: casting and off-loading shoe. The rate of bone healing was investigated. Also, patients' satisfaction and the pain severity were measured before and after treatment. The AFAOS (American Orthopaedic Foot and Ankle Society) was completed. The treatment results were compared between the two groups. The patients were followed for 36.5±4.2 days in group C and 33.3±4.7 days in OS group (p < /em>≥.05). Results: Clinical and radiolographic success were achieved in all of the cases and all the patients returned to their previous activities. At final visit, the pain intensity was as follows: 5.4±1.4 in group C versus 5.9±1.1 in group OS (p < /em>≥.05). The AOFAS was 92.3±14.7 points in group C and 94.5±12.3 in group OS Two patients developed skin problems and another one developed symptoms of deep venous thrombosis, all in group C. Conclusions: Off-loading shoes are suitable tools to treat forefoot fractures. Although no significant difference was found between the two groups, but due to satisfactory outcome and lack of complication, off-loading shoes are recommended in non-operative treatment of forfoot fractures. 

Keywords

Forefoot
bone fracture
Plaster cast
Shoes

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