Metatarsal Stress Fracture #

Question 1

Common Causes

Answer 1

• Recent increase in Load
• Short 1st or long 2nd metatarsal
• Osteoporosis, osteomalacia
• 1st met not accepting load, Lesser toes must accept

Question 2

signs and symptoms

Answer 2

• Tenderness and Local pain at forefoot
• Swelling
• Worse when weight bearing and palpation
• pain worsens during activity

Question 3

diagnosis

Answer 3

• History of increase load
• focal tenderness when palpating
• imaging, MRI for early detection, X-ray may not pick up # for 2-6 weeks

Question 4

DDx

Answer 4

• Plantar plate injury

- Neuroma or metatarsalgia

Question 5

Treatment

Answer 5

Stress reaction
-Reduce load, address risk factors 
Stress fracture 
-Offload 4-6 weeks
-Footwear with orthotics to redistribute load
-Graded loading programs 
-Education on risk factors

Question 6

What if the fracture is at the base of metatarsal?

Answer 6

• Result in delayed union
• Restrict weight bearing for 6 weeks
• Common in dancers

Question 7

Why is the 2nd metatarsal more susceptible to fracture?

Answer 7

-longest and most rigid of the mets making it more exposed to greater repetitive stresses