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Short Leg Walking Plaster Cast Versus Walking Foot Cast for Jones Fracture

Not Applicable
Completed
Conditions
Jones Syndrome
Metatarsal Bone Fractures
Registration Number
NCT06687668
Lead Sponsor
Khyber Medical University Peshawar
Brief Summary

This study is an open-label, randomized controlled trial comparing the effectiveness of two plaster cast methods-Short Leg Walking Plaster Cast and Walking Foot Plaster Cast-for treating Jones fractures, a common fracture at the base of the fifth metatarsal in the foot. This trial will be conducted at Lady Reading Hospital Peshawar. The study will evaluate differences in fracture healing and functional outcomes between these two treatment approaches. Findings from this trial may guide more evidence-based treatment protocols for Jones fractures, potentially improving patient mobility and recovery without requiring surgical intervention.

Detailed Description

Jones fractures represent 26.3% of fractures at the base of the fifth metatarsal and are commonly treated conservatively through various weight-bearing casts. The lack of consensus on the optimal casting method for Jones fractures necessitates further study, particularly given the absence of published guidelines. This trial, unique in its randomized and prospective approach within Pakistan, aims to compare Short Leg Walking Plaster Casts and Walking Foot Plaster Casts specifically for Jones fractures.

Patients meeting the inclusion criteria will be randomly assigned to one of the two treatment groups, with the primary endpoints being fracture healing (union) and functional outcomes at six weeks, assessed via radiographs and the American Orthopaedic Foot and Ankle Score (AOFAS). This study seeks to produce robust evidence to inform treatment guidelines, allowing patients, especially in low- and middle-income settings, to continue daily activities with minimal disruption during recovery.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
122
Inclusion Criteria
  • Both genders
  • 18 years and above
  • Jones fractures that are un-displaced or minimally displaced (less than 2 mm)
  • Fractures presented within 7 days of injury
Exclusion Criteria
  • Significant foot swelling
  • Open fractures
  • Ipsilateral foot, ankle, or lower limb soft tissue pathology or fractures
  • Pathological fractures

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Fracture Union Rate6 weeks after cast application.

Measurement of fracture healing defined by callus formation and obliteration of the fracture line in 2 out of 3 cortices (lateral, medial, plantar) on X-ray, and absence of pain and tenderness at the fracture site, assessed by a senior orthopedic consultant.

Delayed Union Rate6 weeks, with further assessment at 8 weeks if needed.

Defined by insufficient callus in fewer than 2 cortices and persistent pain and tenderness at the fracture site. This assessment determines cases where additional casting or intervention may be necessary.

Nonunion Rate8 weeks post-cast application.

Nonunion is confirmed if there is insufficient callus formation in fewer than 2 cortices, with persistent pain and tenderness at the fracture site.

Functional Outcome (American Orthopaedic Foot and Ankle Score - AOFAS)6 weeks after cast removal.

Functional outcome assessed via the AOFAS scoring system, which includes pain (40 points), function (50 points), and alignment (10 points), with higher scores indicating better function.

Secondary Outcome Measures
NameTimeMethod
ComplicationThroughout the study duration up to 8 weeks.

Incidence of any complications, such as cast-related issues, skin irritation, or infection, during and after cast application.

Trial Locations

Locations (1)

Lady Reading Hospital, Pakistan

🇵🇰

Peshawar, Khyber Pakhtunkhwa, Pakistan

Lady Reading Hospital, Pakistan
🇵🇰Peshawar, Khyber Pakhtunkhwa, Pakistan

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