Biomechanical Comparison of Cannulated Screw Osteosynthesis With Tension-Band Wiring for Proximal Fractures of the Fifth Metatarsal (Jones Fracture)

Jones fractures, which lie at the junction of the diaphysis to the metaphysis of the fifth metatarsal, are a well -described clinical issue. There are various surgical approaches, including the commonly performed cannulated screw osteosyntheses, and the less frequently used tension-band approach. The aim is to compare the biomechan-ical stability of these osteosyntheses. We performed an osteotomy on 16 fresh frozen fifth metatarsal bones from body donors representing a Jones fracture. The fractures were treated pairwise with screw osteosynthesis or ten-sion-band wiring. This was followed by cyclic axial bending until osteosynthesis failure. Stability under axial bend-ing force was higher in the screw osteosynthesis (mean: 70.0 +/- 66.5 N) compared to the tension-band wiring (mean: 35.7 +/- 23.3 N) group although not reaching statistical significance (p = .116). The study shows no statisti-cally significant difference in biomechanical stability under axial loading between screw osteosynthesis and ten-sion band wiring. Based on the data obtained, no differences can be observed from a biomechanical point of view. The study supports the established method of treating Jones fractures primarily with screw osteosynthesis. In addition, the data suggest that tension band wiring may be a good alternative osteosynthesis, for example, after failed casting treatment or failure of primary osteosynthesis.(c) 2022 The Author(s). This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)