578 results match your criteria Metatarsal Stress Fracture


Medical and Biomechanical Risk Factors for Incident Bone Stress Injury in Collegiate Runners: Can Plantar Pressure Predict Injury?

Orthop J Sports Med 2022 Jun 15;10(6):23259671221104793. Epub 2022 Jun 15.

Stanford Medical Center, Redwood City, California, USA.

Background: Bone stress injury (BSI) is a common reason for missed practices and competitions in elite track and field runners.

Hypothesis: It was hypothesized that, after accounting for medical risk factors, higher plantar loading during running, walking, and athletic movements would predict the risk of future BSI in elite collegiate runners.

Study Design: Cohort study; Level of evidence, 2. Read More

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Effects of badminton insole design on stress distribution, displacement and bone rotation of ankle joint during single-leg landing: a finite element analysis.

Sports Biomech 2022 Jun 20:1-22. Epub 2022 Jun 20.

Bioinspired Devices and Tissue Engineering (BIOINSPIRA) Research Group, School of Biomedical Engineering and Health Sciences, Faculty of Engineering, Universiti Teknologi Malaysia, Johor Bahru, Malaysia.

Previous research has reported that up to 92% of injuries amongst badminton players consist of lower limb, whereby 35% of foot fractures occurred at the metatarsal bone. In sports, insoles are widely used to increase athletes' performance and prevent many injuries. However, there is still a lack of badminton insole analysis and improvements. Read More

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Frequent fractures and sclerotic thick bands on physes related to oral alendronate treatments.

Trauma Case Rep 2022 Jun 30;39:100644. Epub 2022 Apr 30.

Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Japan.

Bisphosphonate treatment has known effects of improving bone mineral density and preventing fractures in children with steroid-induced osteoporosis. However, there have been reports that high-dosage pamidronate therapy induces osteopetrosis in the borders of bones. A 10-year-old boy undergoing long-term treatment with oral alendronate developed frequent fractures throughout adolescence while playing basketball. Read More

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An Abnormal Presentation of Pediatric Genu Varum, Managed by Bilateral Tibial and Fibular Osteotomies With External Spatial Frame Placement: A Case Report.

Cureus 2022 Apr 8;14(4):e23953. Epub 2022 Apr 8.

Education, Franklin Hospital, Floral Park, USA.

Genu varum is a common finding in the pediatric population with a large differential, including but not limited to Blount's disease, rickets, and physiologic bowing of the legs. Here we report a case of a 12-year-old Caucasian male who presented for an atraumatic stress fracture of the fifth metatarsal after an athletic event. Further evaluation showed significant genu varum with a Q angle of 9 degrees and medial knee joint space narrowing. Read More

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Stress Fractures in the Forefoot After Arthrodesis of the Hindfoot in a Patient with Rheumatoid Arthritis: A Case Report.

Mod Rheumatol Case Rep 2022 Apr 23. Epub 2022 Apr 23.

Department of Orthopedic Surgery, Tokyo Women's Medical University, Tokyo, Japan.

Rheumatoid arthritis (RA) is an autoimmune disease that attacks multiple joints throughout the body. Ankle arthrodesis (AA) has been the gold standard surgery for end-stage ankle arthritis in patients with RA. Here, we report the case of a 67-year-old woman with RA who had displacement and loosening of total ankle arthroplasty (TAA). Read More

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Bone-microarchitecture and bone-strength in a sample of adults with hypophosphatasia and a matched reference population assessed by HR-pQCT and impact microindentation.

Bone 2022 07 11;160:116420. Epub 2022 Apr 11.

Dept. of Endocrinology, Copenhagen University Hospital Hvidovre, Kettegaard Alle 30, 2650 Hvidovre, Denmark; Dept. of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3 B, 2200 Copenhagen, Denmark.

Background: Hypophosphatasia (HPP) is an autosomal recessive or dominate disease affecting bone mineralization, and adults with HPP are in risk to develop metatarsal stress fractures and femoral pseudofractures. Given to the scarce data on the bone quality and its association to the fracture risk in adults with HPP, this study aimed to evaluate bone turnover, bone strength and structure in adults with HPP.

Methods: In this cross-sectional study, we included 14 adults with genetically verified HPP and 14 sex-, age-, BMI-, and menopausal status-matched reference individuals. Read More

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Asymptomatic foot and ankle structural injuries: a 3D imaging and finite element analysis of elite fencers.

BMC Sports Sci Med Rehabil 2022 Mar 27;14(1):50. Epub 2022 Mar 27.

Foot Research Laboratory, Key Laboratory of Sport and Health Science of Fujian Province, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, 350117, China.

Background: Fencing is a highly asymmetrical combat sport, that imposes high mechanical demands over repeated exposures on the musculoskeletal structures, a primary cause of injuries in fencers. However, there are limited epidemiological studies on the structural injuries of the foot and ankle in fencers. This study aimed to investigate foot and ankle structural injuries, and explore how metatarsophalangeal joint structural changes may affect the mechanisms of foot and ankle injuries in asymptomatic fencers. Read More

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Comparison of Ultrasonography to MRI in the Diagnosis of Lower Extremity Bone Stress Injuries: A Prospective Cohort Study.

J Ultrasound Med 2022 Mar 22. Epub 2022 Mar 22.

Department of Orthopaedic Surgery, Division of Physical Medicine and Rehabilitation, Stanford University School of Medicine, Stanford, CA, USA.

Objective: To determine the sensitivity and specificity of ultrasound imaging (USI) compared to the reference-standard of MRI in the diagnosis of bone stress injury (BSI).

Methods: A prospective blinded cohort study was conducted. Thirty seven patients who presented to an academic sports medicine clinic from 2016 to 2020 with suspected lower-extremity BSI on clinical exam underwent both magnetic resonance imaging (MRI) and USI. Read More

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Orthosis and Foot Structure Affect the Fifth Metatarsal Principal Strains During Simulated Level Walking.

Am J Sports Med 2022 05 18;50(6):1659-1667. Epub 2022 Mar 18.

Hospital for Special Surgery, New York, New York, USA.

Background: Fractures of the proximal fifth metatarsal bone are common injuries in elite athletes and are associated with high rates of delayed union and nonunion. Structural features of the foot may increase fracture risk in some individuals, emphasizing the need for intervention strategies to prevent fracture. Although orthotic devices have shown promise in reducing fractures of the fifth metatarsal bone, the effect of orthosis on fifth metatarsal strains is not well understood. Read More

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Age and Female Sex Are Important Risk Factors for Stress Fractures: A Nationwide Database Analysis.

Sports Health 2022 Mar 4:19417381221080440. Epub 2022 Mar 4.

Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana.

Background: Stress fractures are caused by micro-trauma due to repetitive stress on bone, common in active individuals and athletes. Previous studies demonstrate that the weightbearing bones of the lower extremities incur stress fractures most often, especially in women and older adults.

Hypothesis: Prior literature does not quantify the difference in frequency of stress fractures among different genders, age groups, or body mass indices (BMIs). Read More

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Predictive factors for the bone union disorder of intramedullary screw fixation in proximal fifth metatarsal bone fractures.

Arch Orthop Trauma Surg 2022 Mar 2. Epub 2022 Mar 2.

Department of Sports Orthopedics Surgery, Kanto Rosai Hospital, 1-1, Kizuki Sumiyoshi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-8510, Japan.

Introduction: Although intramedullary screw fixation likely leads to successful union of Jones fractures compared to that of nonoperative treatments, bony union disorder after surgical treatment remains to be elucidated.

Methods: Intramedullary screw fixation was performed for the surgical treatment of proximal fifth metatarsal stress fractures in this series. Between January 2008 and December 2019, the feet of 222 patients were investigated regarding the effective factors for postoperative bony union between the normal union group and the bony union disorder group according to the patients' physical status, radiological assessment, and screw size. Read More

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Acute, isolated fractures of the metatarsal bones: an epidemiologic study.

Arch Orthop Trauma Surg 2022 Mar 2. Epub 2022 Mar 2.

Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Ziemssenstr. 5, 80336, Munich, Germany.

Introduction: Although metatarsal fractures are common, the significance of previous epidemiologic studies is limited to specific fracture entities, subpopulations, or heterogeneous fracture aetiologies. The aim of the study was to assess the epidemiology of isolated metatarsal fractures in an adult population at a level-1 trauma centre.

Materials And Methods: Radiological and clinical databases were searched for a five-year period. Read More

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Metatarsal Bone Marrow Edema on Magnetic Resonance Imaging and Its Correlation to Bone Stress Injuries in Male Collegiate Basketball Players.

Orthop J Sports Med 2022 Jan 17;10(1):23259671211063505. Epub 2022 Jan 17.

Massachusetts General Hospital, Boston, Massachusetts, USA.

Background: The presence of bone marrow edema (BME) on magnetic resonance imaging (MRI) has been used to evaluate for bone stress injuries in athletes.

Purpose: To examine the prevalence of MRI findings, including BME, in a single male collegiate basketball team before and after a single season and to assess its association with clinically symptomatic metatarsal bone stress injuries.

Study Design: Cohort Study; Level of evidence, 3. Read More

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January 2022

Less Invasive Surgery With Autologous Bone Grafting for Proximal Fifth Metatarsal Diaphyseal Stress Fractures.

J Foot Ankle Surg 2022 Jul-Aug;61(4):807-811. Epub 2021 Dec 7.

Department of Sports Orthopedic Surgery, Kanto Rosai Hospital, Kanagawa, Japan.

Surgery with autologous bone grafting for proximal fifth metatarsal diaphyseal stress fracture has a potential to decrease nonunion, but it is not performed widely as the primary surgery because of donor-site morbidity. We have devised and performed a less invasive surgical procedure with autologous bone grafting and aimed to investigate the clinical and radiologic outcomes of this procedure. The data for 73 patients who underwent primary intramedullary screw fixation with autologous bone grafting from the fifth metatarsal base for proximal fifth metatarsal diaphyseal stress fractures were investigated retrospectively. Read More

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December 2021

Osteoid osteoma of the second metatarsal bone diagnosed on MRI: A case report and literature review.

Radiol Case Rep 2022 Mar 9;17(3):423-426. Epub 2021 Dec 9.

Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.

Osteoid osteoma is a relatively common benign bone tumor that is most frequently seen on the appendicular skeleton in adolescents and young adults. Here we present the case of a 14-year-old boy presenting with a 10 month history of pain in his left foot which had been misdiagnosed as stress fracture due to its unusual clinical presentation. Magnetic resonance imaging of the left foot revealed a bone lesion with typical features of the osteoid osteoma on the distal part of the second metatarsal bone. Read More

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The Metatarsal Cortical Index as an Indicator of Insufficiency Fracture of the Foot.

J Foot Ankle Surg 2022 May-Jun;61(3):637-640. Epub 2021 Nov 1.

Resident, Department of Orthopaedics, Cantonal Hospital Baden, Baden, Switzerland.

The diagnosis of metatarsal stress fractures is challenging. Standard imaging often shows false-negative results. The aim of this study was to create reliable radiologic outcome parameters to predict insufficiency fractures of the metatarsals. Read More

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Clinical and Biomechanical Progression after Ankle Joint Distraction in a Young Adolescent Patient with Haemophilia.

Int J Environ Res Public Health 2021 10 29;18(21). Epub 2021 Oct 29.

Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Spoorwegstraat 12, B-8200 Brugge, Belgium.

Ankle joint distraction (AJD) has been described to be a valuable joint-sparing alternative to arthrodesis or arthroplasty; however, clinical endpoints associated to this surgical intervention are lacking. The current case report describes clinical and biomechanical outcome measures of ankle joint distraction in a 14-year-old patient with severe haemophilia A. Because of persistent and incapacitating pain and the poor response to conservative and invasive treatment options, ankle joint distraction was performed in this 14-year-old patient using an external fixator encompassing two Ilizarov full rings in the tibia and a foot ring fixed to the foot by four K-wires. Read More

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October 2021

Fractures of the Base of the Fifth Metatarsal Bone: A Critical Analysis Review.

JBJS Rev 2021 10 21;9(10). Epub 2021 Oct 21.

University Center of Orthopaedics and Traumatology, University Hospital Carl Gustav Carus Dresden, Dresden, Germany.

»: Fractures of the proximal fifth metatarsal (PFMT) are one of the most common foot injuries, accounting for 61% to 78% of all foot fractures, but full consensus on their classification, diagnosis, and treatment has not yet been reached.

»: The most commonly accepted classification is that of Lawrence and Botte, who divided the location of PFMT fractures into 3 zones with respect to their healing potential.

»: Avulsion fractures of the tuberosity of the base (zone 1) generally heal well, and nonoperative treatment is commonly recommended. Read More

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October 2021

The Effectiveness of Intramedullary Screw Fixation Using the Herbert Screw for Fifth Metatarsal Stress Fractures in High-Level Athletes.

Am J Sports Med 2021 12 15;49(14):4001-4007. Epub 2021 Oct 15.

Ogihara Orthopaedic Hospital, Kobe, Hyogo, Japan.

Background: Intramedullary screw fixation is the most common operative procedure used for treatment of fifth metatarsal stress fractures in athletes. However, the optimal implant in intramedullary screw fixation is still being investigated.

Purpose: To review experiences with intramedullary screw fixation using the Herbert screw for fifth metatarsal stress fractures in high-level athletes. Read More

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December 2021

Bone stress injuries in the presence of tarsal coalition as a cause of hindfoot pain in adolescents: case series of 6 patients with literature review.

Skeletal Radiol 2022 May 24;51(5):991-996. Epub 2021 Sep 24.

Departments of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Bristol Road South, Birmingham, B21 3AP, UK.

Objective: To highlight causal relationship between stress fracture in the presence of tarsal coalition and hindfoot pain in adolescents on magnetic resonance imaging (MRI).

Material And Methods: A retrospective review was performed of the clinical and MRI imaging findings of 6 adolescents referred for MRI to evaluate symptoms of hindfoot pain with possible tarsal coalition. MRI studies were systematically assessed for cause of hindfoot pain, types of tarsal coalition, patterns of stress fractures, bone marrow oedema and any other associated features. Read More

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Hypophosphatasia: An Underappreciated Cause of Atraumatic Stress Fractures.

Am J Med 2022 01 17;135(1):e18-e19. Epub 2021 Sep 17.

Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany; Laboratory of Metabolic Liver Diseases, Department of General, Transplant and Liver Surgery, Centre for Preclinical Research, Medical University of Warsaw, Poland. Electronic address:

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January 2022

Three-Dimensional Finite Element Analysis and Biomechanical Analysis of Midfoot von Mises Stress Levels in Flatfoot, Clubfoot, and Lisfranc Joint Injury.

Med Sci Monit 2021 Aug 29;27:e931969. Epub 2021 Aug 29.

Department of Orthopedics, Mingdong Hospital affiliated to Fujian Medical University, Ningde, Fujian, China (mainland).

BACKGROUND Midfoot deformity and injury can affect the internal pressure distribution of the foot. This study aimed to use 3D finite element and biomechanical analyses of midfoot von Mises stress levels in flatfoot, clubfoot, and Lisfranc joint injury. MATERIAL AND METHODS Normal feet, flatfeet, clubfeet (30 individuals each), and Lisfranc injuries (50 individuals) were reconstructed by CT, and 3D finite element models were established by ABAQUS. Read More

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Can low-intensity pulsed ultrasound (LIPUS) accelerate bone healing after intramedullary screw fixation for proximal fifth metatarsal stress fractures? A retrospective study.

BMC Musculoskelet Disord 2021 Aug 23;22(1):725. Epub 2021 Aug 23.

Department of Sports Orthopaedic Surgery, Kanto Rosai Hospital, 1-1 Kizukisumiyoshi-cho, Nakahara-ku, Kawasaki, Kanagawa Prefacture, Japan.

Background: Intramedullary screw fixation is considered the standard treatment for proximal fifth metatarsal stress fractures. Low-intensity pulsed ultrasound (LIPUS) is a well-known bone-healing enhancement device. However, to the best of our knowledge, no clinical study has focused on the effect of LIPUS for postoperative bone union in proximal fifth metatarsal stress fractures. Read More

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Outcomes of Surgically Treated Fifth Metatarsal Fractures in Major League Soccer Athletes.

Am J Sports Med 2021 09 6;49(11):3014-3020. Epub 2021 Aug 6.

University of California, Davis, Sacramento, California, USA.

Background: Sports-related fractures of the fifth metatarsal are common in professional athletes. Data regarding outcomes of surgical management including refracture, complications, and return-to-play statistics are available for other professional American sports with a notable exception of soccer.

Purpose: To quantify the burden of operative fifth metatarsal fractures in Major League Soccer (MLS) athletes, to compare outcomes as well as refracture and complication rates with other professional sports, to analyze factors that may contribute to treatment failure, and to report on return-to-play characteristics for affected players. Read More

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September 2021

Do non-rearfoot runners experience greater second metatarsal stresses than rearfoot runners?

J Biomech 2021 09 26;126:110647. Epub 2021 Jul 26.

Sport and Health Sciences, University of Exeter, Exeter, UK.

Stress fracture of the second metatarsal is a common and problematic injury for runners. The choice of foot strike pattern is known to affect external kinetics and kinematics but its effect on internal loading of the metatarsals is not well understood. Models of various complexities can be used to investigate the effects of running characteristics on metatarsal stresses. Read More

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September 2021

Diagnosis of Hypophosphatasia in Adults Presenting With Metatarsal Stress Fracture: Proof-of-Concept for a Case-Finding Strategy.

JBMR Plus 2021 Jun 2;5(6):e10495. Epub 2021 Apr 2.

Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism Ohio State University Wexner Medical Center Columbus OH USA.

Hypophosphatasia (HPP) is caused by loss-of-function mutations in resulting in decreased alkaline phosphatase (ALP) activity. Metatarsal stress fracture (MSF) is a common clinical feature of hypophosphatasia in adults. In this study, the primary objectives were to determine whether new cases of variants could be identified in patients with MSF and who also had serum ALP concentration below the reference range and to phenotype their clinical course. Read More

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Conservative Treatment of the Fifth Metatarsal Bone Fractures in Professional Football Players Using Platelet-Rich Plasma.

Foot Ankle Spec 2022 Feb 18;15(1):62-66. Epub 2021 Jun 18.

Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.

Injuries of the metatarsal bones in football are relatively rare and in most cases are localized in the fifth metatarsal. The gold standard of the diagnosis of fractures in this area can be X-rays, which in most cases allows verifying the diagnosis. The treatment tactics depend on the localization of the fracture according to Lawrence and Botte's classification: 3 zones of localization are distinguished. Read More

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February 2022

Optimal Load for Managing Low-Risk Tibial and Metatarsal Bone Stress Injuries in Runners: The Science Behind the Clinical Reasoning.

J Orthop Sports Phys Ther 2021 07 7;51(7):322-330. Epub 2021 May 7.

Background: Low-risk bone stress injuries (BSIs) of the tibia and metatarsal diaphyses account for more than half of BSIs in runners. They interrupt training and are managed using noninvasive approaches that are designed to achieve a speedy but safe return to running.

Clinical Question: What is the optimal load to manage low-risk tibial and metatarsal BSIs and safely return to running?

Key Results: Optimal load can be guided by knowledge of the BSI healing process and is symptom driven. Read More

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Stress Fractures of the Fifth Metatarsal in Athletes.

J Am Acad Orthop Surg 2021 Jun;29(12):507-517

From the Mayo Clinic Arizona, Phoenix, AZ (Patel, Christopher), Chilton Medical Center, Pompton Plains, NJ (Hubbard), and the Hospital for Special Surgery (O'Malley), New York, NY.

Stress fractures of the fifth metatarsal (zones 2 and 3) remain a challenging clinical problem. It has been well established that nonsurgical treatment has unacceptably high nonunion and refracture rates. Surgical fixation remains the treatment of choice in the athletic cohort, and intramedullary screw fixation with a solid screw has been established as the most predictable means of achieving a successful outcome. Read More

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