ABSTRACT
For acute Jones' fractures in recreationally active patients, early intramedullary screw fixation results in lower failure rates and shorter times to both clinical union and return to sports than non-weightbearing short leg casting (strength of recommendation [SOR]: A, based on 2 randomized controlled trials [RCT]). Non-weightbearing short leg casting achieves union in 56% to 100% of patients but can require prolonged casting (SOR: B, based on 2 prospective cohorts and multiple retrospective, follow-up studies). Stress fractures were not included in this review. For avulsion fractures of the fifth metatarsal tuberosity, a soft Jones' dressing allows earlier return to pre-injury levels of activity than rigid short leg casting (SOR: B, based on a lower-quality RCT).
Subject(s)
Fractures, Bone/surgery , Metatarsal Bones/injuries , Metatarsal Bones/surgery , Acute Disease , Bone Screws , Casts, Surgical , Clinical Trials as Topic , Evidence-Based Medicine , Fracture Fixation, Intramedullary , Fracture Healing , Humans , Metatarsal Bones/physiology , Weight-BearingABSTRACT
With the ever-increasing call to reduce self-imposed regulatory and administrative burden in the animal research oversight process, knowledge of the regulations and a desire to streamline policies and procedures are needed to affect a change in culture. In this opinion piece, we provide details on why institutionally imposed regulatory burden can arise.