RESUMEN
BACKGROUND: Fifth metatarsal basis fractures are common injuries. Zone 1 fractures are also known as pseudo-jones fractures. This study aimed to elucidate the impact of foot radiologic morphology on pseudo-Jones fractures. METHODS: Patients with pseudo-Jones fractures formed the case group and individuals with ankle sprains but no fractures formed control group. Weight-bearing anteroposterior and lateral radiographs were evaluated for pre-determined measurements: metatarsus adductus angle (MAA), intermetatarsal angles (1-2, 4-5), calcaneal inclination (CI) angle, and fifth metatarsal base angle. All measurements were performed by a single investigator using digital PACS tools. Statistical analysis compared these radiographic parameters between the groups. RESULTS: The fracture group demonstrated a significantly lower 4-5 intermetatarsal and calcaneal inclination angles than the control group (p < 0.05). Notably, no statistically significant difference was found in the metatarsus adductus angle. CONCLUSION: This study demonstrates a potential association between foot radiographic morphology and pseudo-Jones fractures. Patients with a lower 4-5 IMA and calcaneal inclination angle may be at a higher risk for developing pseudo-Jones fractures. However, these requires future prospective studies. LEVEL OF EVIDENCE: Level III case control study.
RESUMEN
BACKGROUND: This study presents a new fluoroscopy-controlled approach in patients with chronic traumatic coccydynia by applying ganglion impar block using the needle-inside-needle technique from the intercoccygeal region without the administration of contrast material. With this approach, the cost and possible side effects of using contrast material can be prevented. In addition, we examined the long-term effect of this method. METHODS: The study was designed retrospectively. The marked area was entered with a 21-gauge needle syringe, and 3 cc of 2% lidocaine was administered subcutaneously by local infiltration. A 25-gauge 90 mm spinal needle was inserted into the guide 21-gauge 50 mm needle tip. The location of the needle tip was controlled under fluoroscopy, and 2 mL of 0.5% bupivacaine and 1 mL of be-tamethasone acetate were mixed and administered. RESULTS: A total of 26 patients with chronic traumatic coccydinia participated in the study between 2018 and 2020. The average procedure time was approximately 3.19 min. The mean time of pain relief of more than 50% was 1.25±1.22 (1st min-72 h) min. The mean Numerical pain rating scale scores were 2.38±2.26 at 1 h, 2.50±2.30 at 6 h, 2.50±2.21 at 24 h, 3.73±2.20 at 1 month, 4.46±2.14 at 6 months 1 and 5.23±2.52 at 1 year. CONCLUSION: Our study shows that as an alternative in patients with chronic traumatic coccydynia, the long-term results of the needle-inside-needle method from the intercoccygeal region without contrast material are safe and feasible.
