title: Fracture of the second metatarsal base. An overlooked cause of chronic midfoot pain.
abstract: Fracture of the second metatarsal is a cause of chronic midfoot pain that has not been thoroughly examined in the literature. A retrospective review of medical charts and imaging studies was undertaken to investigate this phenomenon. The clinical presentation, differential diagnosis, results of imaging studies, and treatment modalities are described for eight patients with midfoot pain who were treated for a mean of 3.7 months (range, 0 to 12 months) before imaging studies showed a nondisplaced transverse fracture of the second metatarsal base. Initial radiographs indicated fracture in only one patient. Two patients later had surgical bone grafting, two patients had asymptomatic nonunion, and three patients eventually healed. At the last follow-up examination, one patient was continuing treatment with immobilization and electrical bone stimulation. For the seven patients in whom symptoms resolved, the mean recovery period was 14 months (range, 5 to 23 months). Further research is needed to improve treatment and outcomes for this condition.
authors.affiliation: Division of Podiatric Surgery, Department of Orthopedics, Podiatry, and Sports Medicine, Kaiser Permanente Medical Center, Santa Clara, CA, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Morris
authors.forename: Kelly
authors.initials: K
authors.lastname: Nix
authors.forename: Flair D
authors.initials: FD
authors.lastname: Goldman
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D050723:Fractures, Bone / Q000150:complications* / Q000628:therapy; D005599:Fractures, Ununited / Q000150:complications; D006801:Humans; D007103:Immobilization; D008297:Male; D008682:Metatarsal Bones / Q000293:injuries*; D008684:Metatarsus; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D012189:Retrospective Studies