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Abstract Objective To compare the suture anchor and Herbert screw in the treatment of zone I fracture of the fifth metatarsal base.Methods We studied 46 cases of zone I fracture of the fifth metatarsal base treated surgically in our hospital from January 2013 to December 2017，including 21 males and 25 females.The patients aged 17 to 58 years，with an average age of (37.9±5.1).They were divided into two groups according to different internal fixation methods：24 cases in the suture anchor group and 22 cases in the Herbert screw group.The operative time，intraoperative blood loss，intraoperative fluoroscopy frequency，weight bearing time，fracture healing time，fracture displacement cases and functional recovery of the affected foot were compared between the two groups.Results The follow-up period ranged from 12 to 18 months，with an average of (14.5±1.6)months.The incision healed normally in all 46 cases，and no incision infection or osteomyelitis occurred.In the suture anchor group，the operation time was (13.0±1.5)minutes，the amount of bleeding was (8.5±3.4)mL，the number of fluoroscopy was (2.1±1.5)times，the time of beginning weightbearing was (6.1±0.4)weeks，the time of fracture healing was (8.2±0.5)weeks.Thre was 1 case of fracture displacement and the Maryland foot function score was (93.2±4.2)points in 6 months after operation.In Herbert screw group，the operation time was (22.0±3.8)minutes，the amount of bleeding was (15.6±5.7)mL，the number of fluoroscopes was (5.0±2.7)times，the time of starting weight-bearing was (8.1±0.5)weeks，the time of fracture healing was (9.2±0.5)weeks.There was 1 case of displaced fracture，and the Maryland foot function score was (85.2±5.5)points in 6 months after operation.Conclusion Compared with Herbert screw，suture anchor has obvious advantages in operation time，bleeding volume，fluoroscopy frequency，weightbearing time，fracture healing time and ankle joint function in the treatment of zone I fracture of the fifth metatarsal base，but there is no difference in fixation firmness.
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