Dislocation/Fracture of Proximal 5th Metatarsal: New Protocol with Self-Assessment Scale and Specific Plantar Orthosis

Background. Metatarsal dislocations/fractures represent a significant proportion of foot injuries. There has been conflicting literature on the management of proximal 5th metatarsal injury, due to inconsistency concerning the classification of these conditions. Various patterns of metatarsal injuries exist and the resultant impact on function and quality of life is not negligible. A complete clinical and radiological assessment is needed to propose treatment options tailored to the clinical and functional needs of the individual metatarsal dislocation/fracture. Proximal 5th metatarsal dislocations/fractures generally occur in active young men involved in organized sports in their second to third decades of life, but not only; the condition often affects even middleaged adults with a very active life and with strong demands functional (e.g. dance, running, hunting). Aims. 1) To develop a new clinical-functional scale that allows patients to self-assess the severity of their injury and monitor its progression. 2) To design an innovative foot orthosis for the non-surgical management of mild to moderate proximal 5th metatarsal dislocations/fractures. Methods. Critical evaluation of the literature for understanding the topic at hand with subsequent design of the proposed rating scale and orthosis. Expected Results. The introduction of a patient-centric scale and a custom orthosis could enhance the self-management of proximal 5th metatarsal injuries, potentially improving the quality of life and functional outcomes for patients. Conclusions. Addressing the gap in the management of proximal 5th metatarsal injuries, this study aims to contribute a practical scale and a novel orthotic device, fostering patient empowerment and offering a non-operative alternative treatment.