{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:57:54Z","timestamp":1787497074489,"version":"build-2736575974"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T00:00:00Z","timestamp":1609200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of this study was to determine the rate of delayed or nonunion of fifth metatarsal fractures in skeletally immature patients. Using this information, we sought to develop an evidence-based clinical care pathway in order to mitigate unnecessary patient radiation exposure, costs to families, and costs to the health system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed the charts and radiographs of patients who presented to an academic tertiary-care paediatric hospital between 2009 and 2014 with isolated fifth metatarsal fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 114 patients (61 males and 53 females) with mean age of 11.2 (SD 3.0) years old were included in the study. No patients required operative management. There was one case of delayed union and no cases of nonunion. There was no association of these complications with fracture type, location, or mechanism of injury. There was no association of complications with immobilization type or immobilization period. Despite the low complication rate and need for surgery, fracture clinic resource utilization was significant. Fractures were managed with a mean number of 3.1 (SD 0.89) clinic visits and a mean number of 2.7 (SD1.0) radiology department visits where a mean total of 7.9 (SD 3.4) x-rays were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Based on our retrospective review, skeletally immature patients presenting with isolated fifth metatarsal fractures have a very low rate of delayed or nonunion. A selective follow-up strategy will decrease radiation exposure, reduce costs to families and the healthcare system, without compromising clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/pch\/pxaa124","type":"journal-article","created":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T07:09:57Z","timestamp":1609225797000},"page":"349-352","source":"Crossref","is-referenced-by-count":3,"title":["Fifth metatarsal fractures in skeletally immature patients do not need routine orthopedic surgeon assessment and follow-up"],"prefix":"10.1093","volume":"26","author":[{"given":"Danielle","family":"Meschino","sequence":"first","affiliation":[{"name":"Division of Orthopaedics, The Hospital for Sick Children, Toronto, Ontario"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Adamich","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics, The Hospital for Sick Children, Toronto, Ontario"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliane","family":"Rioux Trottier","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics, The Hospital for Sick Children, Toronto, Ontario"},{"name":"Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Camp","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics, The Hospital for Sick Children, Toronto, Ontario"},{"name":"Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,12,29]]},"reference":[{"issue":"8","key":"2021091719312573700_CIT0001","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/0020-1383(95)00121-O","article-title":"A study of metatarsal fractures in children","volume":"26","author":"Owen","year":"1995","journal-title":"Injury"},{"key":"2021091719312573700_CIT0002","author":"Introduction to Fractures & Dislocations of the Foot | Rockwood and\u2026 [Internet]","year":"2020"},{"issue":"6","key":"2021091719312573700_CIT0003","doi-asserted-by":"crossref","first-page":"776","DOI":"10.2106\/00004623-197860060-00008","article-title":"The Jones fracture revisited","volume":"60","author":"Kavanaugh","year":"1978","journal-title":"J Bone Joint Surg Am"},{"issue":"5","key":"2021091719312573700_CIT0004","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.injury.2005.12.010","article-title":"The socio-economical impact of paediatric fracture clinic appointments","volume":"37","author":"Morris","year":"2006","journal-title":"Injury"},{"key":"2021091719312573700_CIT0005","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1186\/1756-0500-7-96","article-title":"Paediatric fracture clinic design\u2013current practice and implications for change","volume":"7","author":"Huntley","year":"2014","journal-title":"BMC Res Notes"},{"issue":"4","key":"2021091719312573700_CIT0006","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1097\/01.bpb.0000271323.56610.da","article-title":"Fractures of the fifth metatarsal in children and adolescents","volume":"27","author":"Herrera-Soto","year":"2007","journal-title":"J Pediatr Orthop"},{"issue":"2","key":"2021091719312573700_CIT0007","doi-asserted-by":"crossref","first-page":"209","DOI":"10.2106\/00004623-198466020-00007","article-title":"Fractures of the base of the fifth metatarsal distal to the tuberosity. 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