•  
  •  
 

Abstract

Background: Proximal fifth metatarsal fractures are common. The authors previously performed a study examining the inter- and intraobserver reliability of the Lawrence and Botte Classification, which showed poor interobserver reliability of 16.67%. A novel approach was proposed for the classification of fifth metatarsal fractures using a mortise ankle radiographic view. Methods: The observers from the authors’ prior study reviewed non-weight bearing mortise views of 20 patients with isolated fifth metatarsal base fractures. These radiographs were identified from the 60 radiographs from the authors’ prior study. Five physicians evaluated the radiographs and classified the fractures as type 1, 2, or 3. Results were then analyzed for interobserver reliability. Results: Five observers reviewed 20 radiographs. Total interobserver reliability was 55.0% (11/20) with a Fleiss’ kappa of 0.565 (moderate agreement). The ankle mortise radiograph agreed with previous anteroposterior, oblique, and lateral radiographs at 56.0%, 57.0%, and 57.0%, respectively. Conclusion: There is poor inter- and intraobserver reliability in the current proximal fifth metatarsal classification system. The use of a mortise radiographic view for classification provides equivocal results in the reliability of classifying proximal fifth metatarsal fractures when compared to the typical 3- view of the foot. A future study should be aimed at a classification system with higher reliability.

Included in

Orthopedics Commons

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.