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The following is a summary of “Comparative study of cannulated compression headless screws and anatomical locking compression hook plates for fracture of fifth metatarsal base in athletes and young adults,” published in the February 2025 issue of the Journal of Orthopaedic Surgery and Research by Cao et al.

This study aimed to evaluate and compare the clinical efficacy and complications of cannulated compression headless screws (CHS) and anatomical locking compression hook plates (LCP) in the surgical management of displaced fractures of the fifth metatarsal base Zone I in athletes and young adults. A retrospective analysis was conducted on 50 patients who underwent surgical fixation between May 2021 and June 2023, with patients categorized into two groups based on the fixation method: the CHS group (n = 20) and the LCP group (n = 30). Collected data included demographic information, preoperative waiting time, length of hospital stay, operative duration, and intraoperative blood loss. Postoperative outcomes were assessed using the visual analogue scale (VAS) for pain, the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score for functional recovery, and the incidence of complications. 

The average follow-up period was 16 months (range: 12–25 months), during which all fractures achieved primary union. The CHS group demonstrated a significantly shorter operative time (p < 0.05), and patients in this group reported lower immediate postoperative pain on the VAS compared to the LCP group (p < 0.05). Functional evaluation at three months postoperatively showed a significantly higher AOFAS midfoot score in the LCP group (p < 0.05); however, no significant differences were observed between the two groups at six and twelve months or at the final follow-up (p > 0.05). Notably, the LCP group exhibited a higher incidence of postoperative complications, including mild to moderate plantar pain in four patients, foreign body sensation in five patients, and hardware removal due to discomfort in seven patients within one year postoperatively. 

In contrast, only one patient in the CHS group reported foreign body sensations. The incidence of complications related to internal fixation was significantly higher in the LCP group (p < 0.05), whereas no cases of infection or sural nerve injury were observed in either group. These findings suggest that while the LCP provides early mobilization and rehabilitation benefits in young, active individuals, it is associated with a higher rate of hardware-related complications. Conversely, CHS fixation offers a less invasive approach with lower postoperative discomfort and a reduced need for implant removal. Therefore, CHS may be a more favorable surgical option for displaced fractures of the fifth metatarsal base Zone I in athletes and young adults, particularly when minimizing implant-related morbidity is a priority. Future studies with larger cohorts and prospective designs are warranted to further validate these findings and optimize treatment strategies for this patient population.

Source: josr-online.biomedcentral.com/articles/10.1186/s13018-025-05529-1