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Metatarsal stress fractures

S B Weinfeld1, S L Haddad, M S Myerson

  • 1Department of Orthopaedic Surgery, Union Memorial Hospital, Baltimore, Maryland, USA.

Clinics in Sports Medicine
|April 1, 1997
PubMed
Summary

Metatarsal stress fractures, common in athletes, result from increased foot load. Most cases heal with nonoperative care, but surgery may be needed for specific fractures or injuries.

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Podiatry

Background:

  • Metatarsal stress fractures arise from increased mechanical load on the foot.
  • They are prevalent in athletes and individuals with foot biomechanical issues, neuropathy, or metabolic disorders.
  • Altered foot mechanics, including hindfoot malalignment, contribute to fracture development.

Purpose of the Study:

  • To review the diagnosis and treatment of metatarsal stress fractures.
  • To identify patient populations and specific fracture types requiring surgical intervention.
  • To emphasize the importance of addressing foot and ankle instability during surgical treatment.

Main Methods:

  • Review of clinical history and physical examination findings.
  • Selective utilization of diagnostic imaging techniques.
  • Analysis of nonoperative and operative treatment strategies.

Main Results:

  • Nonoperative treatment is generally effective for most metatarsal stress fractures.
  • Surgical intervention is indicated for fifth metatarsal stress fractures in athletes and Torg-type-II or III injuries in nonathletes.
  • Surgical technique involves a partially threaded cancellous screw with overdrilling to promote healing.

Conclusions:

  • Metatarsal stress fractures require a thorough diagnostic approach combining clinical assessment and imaging.
  • Treatment strategies should be tailored to the individual patient and fracture characteristics.
  • Addressing associated foot or ankle malalignment and instability is crucial for successful surgical outcomes.

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