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Updated: Jun 16, 2026
Proximal Cadaveric Femur Preparation for Fracture Strength Testing and Quantitative CT-based Finite Element Analysis
Published on: March 11, 2017
Classification scheme for fifth metatarsal base fractures based on CT three-dimensional reconstruction
Haohang Shi1, Wei Wang2, Menglang Peng1
1Department of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China.
Background:
Traditional classifications of fifth metatarsal base (MTB5) fractures often overlook injuries involving the fourth-fifth metatarsal and fifth metatarsal-cuboid joints, contributing to ongoing clinical debate. This study aimed to introduce a novel classification system based on articular involvement, validated through three-dimensional (3D) fracture line mapping and heatmap analysis.
Methods:
Imaging data from 98 patients with MTB5 fractures were retrospectively analyzed. Fracture models were reconstructed using Mimics 21.0, and fracture lines were mapped onto a standard model in 3-matic 13.0. Heatmaps generated in E-3D illustrated fracture patterns. Three reference lines were established to quantify spatial relationships between high-risk fracture areas and joint margins.
Results:
The cohort predominantly comprised patients aged 51-70 years (41.83 %), with a higher incidence among males (53.06 %). Fractures were classified into six types: non-articular (IA: tuberosity, 18.36 %; IB: metaphyseal, 23.46 %; IC: distal to metaphysis, 14.24 %) and articular (IIA: fifth metatarsal-cuboid joint, 36.73 %; IIB: fourth-fifth metatarsal joint, 3.06 %; IIC: both joints, 4.08 %). High-risk zones relative to joint boundaries were quantitatively delineated for each subtype.
Conclusion:
A new six-type classification system for MTB5 fractures is proposed, differentiating non-articular (IA-IC) and articular (IIA-IIC) injuries. Supported by 3D heatmap analysis, this system integrates articular injury patterns, overcomes limitations of previous classifications, and may help guide treatment and improve outcomes.
