• 1

    Chuckpaiwong B, Cook C, Nunley JA: Stress fractures of the second metatarsal base occur in nondancers. Clin Ortop Relat Res 461: 197, 2007.

  • 2

    Chuckpaiwong B, Cook C, Pietrobon R, et al: Second metatarsal stress fracture in sport: comparative risk factors between proximal and non-proximal locations. Br J Sports Med 41: 510, 2007.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 3

    Gehrmann RM, Renard RL: Current concepts review: stress fractures of the foot. Foot Ankle Int 27: 750, 2006.

  • 4

    Hulkko A, Orava S: Stress fractures in athletes. Int J Sports Med 8: 221, 1987.

  • 5

    Queen RM, Crowder TT, Johnson H, et al: Treatment of metatarsal stress fractures: case reports. Foot Ankle Int 28: 506, 2007.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 6

    Rammelt S, Heineck J, Zwipp H: Metatarsal fractures. Injury 35 (suppl 2): SB77, 2004.

  • 7

    Niva MH, Sormaala MJ, Kiuru MJ, et al: Bone stress injuries of the ankle and foot: an 86-month magnetic resonance imaging-based study of physically active young adults. Am J Sports Med 35: 643, 2007.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 8

    Sormaala M: Bone Stress Injuries of the Foot and Ankle [doctoral dissertation], University of Helsinki, Helsinki, Finland, December 2006.

  • 9

    Sterling JC, Calvo RD, Holden SC: An unusual stress fracture in a multiple sport athlete. Med Sci Sports Exerc 23: 298, 1991.

  • 10

    Korpelainen R, Orava S, Karpakka J, et al: Risk factors for recurrent stress fractures in athletes. Am J Sports Med 29: 304, 2001.

  • 11

    Theodorou DJ, Theodorou SJ, Boutin RD, et al: Stress fractures of the lateral metatarsal bones in metatarsus adductus foot deformity: a previously unrecognized association. Skeletal Radiol 28: 679, 1999.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Dusek T, Pecina M, Loncar-Dusek M, et al: Multiple stress fractures in a young female runner. Acta Chir Orthop Traumatol Cech 71: 308, 2004.

  • 13

    Warren MP, Brooks-Gunn J, Fox RP, et al: Lack of bone accretion and amenorrhea: evidence for a relative osteopenia in weight-bearing bones. J Clin Endocrinol Metab 72: 847, 1991.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Griffin NL, Richmond BG: Cross-sectional geometry of the human forefoot. Bone 37: 253, 2005.

  • 15

    Carmont MR, Patrick JH, Cassar-Pullicino VN, et al: Sequential metatarsal fatigue fractures secondary to abnormal foot biomechanics. Mil Med 171: 292, 2006.

  • 16

    Hatch RL, Alsobrook JA, Clugston JR: Diagnosis and management of metatarsal fractures. Am Fam Physician 76: 817, 2007.

  • 17

    Vu D, McDiarmid T, Brown M, et al: Clinical inquiries: what is the most effective management of acute fractures of the base of the fifth metatarsal? J Fam Pract 55: 713, 2006.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18

    Glasoe WM, Allen MK, Kepros T, et al: Dorsal first ray mobility in women athletes with a history of stress fracture of the second or third metatarsal. J Orthop Sports Phys Ther 32: 560, 2002.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19

    Harper MC: Metabolic bone disease presenting as multiple recurrent metatarsal fractures: a case report. Foot Ankle 9: 207, 1989.

  • 20

    Nussbaum AR, Treves ST, Micheli L: Bone stress lesions in ballet dancers: scintigraphic assessment. AJR Am J Roentgenol 150: 851, 1988.

  • 21

    Giladi M, Milgrom C, Kashtan M, et al: Recurrent stress fractures in military recruits: one-year follow-up of 66 recruits. J Bone Joint Surg Br 68: 439, 1986.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation

Multiple Simultaneous Metatarsal Stress Fractures in the Same Foot

Murat Mert Department of Orthopaedics and Traumatology, Istanbul Training and Research Hospital, Istanbul, Turkey.

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Ethem Ayhan Unkar Department of Orthopaedics and Traumatology, Istanbul Training and Research Hospital, Istanbul, Turkey.

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Ali Volkan Ozluk Department of Orthopaedics and Traumatology, Istanbul Training and Research Hospital, Istanbul, Turkey.

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Tolga Tuzuner Department of Orthopaedics and Traumatology, Istanbul Training and Research Hospital, Istanbul, Turkey.

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Sinan Erdoğan Department of Orthopaedics and Traumatology, Istanbul Training and Research Hospital, Istanbul, Turkey.

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Metatarsal stress fractures are common overuse injuries in athletes, military recruits, and ballet dancers, usually occurring in the second, third, and fourth metatarsals, respectively. Such fractures may also occur in a variety of other individuals, regardless of demographic characteristics, sex, or profession, and they are highly associated with excessive activity. Moreover, these types of fractures are usually diagnosed late and have poor outcomes. To our knowledge, there has been only one case report of an individual with stress fractures of all three central metatarsals in the same foot. We describe herein a racehorse training jockey who presented with multiple simultaneous metatarsal stress fractures in the same foot. We also discuss the possible mechanisms by which this entity occurred, as well as its management and outcome.

Corresponding author: Murat Mert, MD, Department of Orthopaedics and Traumatology, Istanbul Training and Research Hospital, Samatya - Fatih, Istanbul, 34098, Turkey. (E-mail: muratmertdr@gmail.com)
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