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First Metatarsal Bilateral Stress Fracture: A Case Report
Leonardo Previ1, Marco Guidi2, Giulia Rescigno1
1Department of Trauma and Orthopaedics, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
Journal of Orthopaedic Case Reports
|May 5, 2023
Summary
This case report details a rare instance of bilateral first metatarsal stress fractures in a runner, highlighting hallux valgus as a potential contributing factor. Treatment involved rest and supportive footwear, leading to symptom resolution.
Area of Science:
- Orthopedics
- Sports Medicine
- Radiology
Background:
- Metatarsal stress fractures commonly affect the second and third metatarsals due to repetitive stress, biomechanical issues, and bone weakness.
- First metatarsal stress fractures are exceptionally rare, with limited documentation in existing literature.
Observation:
- A 52-year-old female runner presented with bilateral forefoot pain after a 20 km run.
- The patient had bilateral hallux valgus (HVA) and first metatarsophalangeal joint osteoarthritis, with radiographic evidence of first metatarsal stress fractures.
Findings:
- The case presents a rare bilateral stress fracture of the first metatarsal.
- Radiographs confirmed linear sclerosis in the diaphysis of both first metatarsals.
- The patient's bilateral hallux valgus may be an indirect indicator of overuse contributing to the fractures.
Implications:
- Bilateral hallux valgus should be considered a potential indirect sign of overuse in athletes presenting with metatarsal stress fractures.
- Further investigation and treatment of HVA may be warranted to address this underlying cause of pathologic bone stress.
