title: Radiographic evaluation of foot structure following fifth metatarsal stress fracture.
abstract: BACKGROUND
  Correlation between foot structure and stress fracture risk has not been adequately evaluated or proven. The purpose of this study was to compare foot structure in fracture cases versus control with respect to radiological parameters in stress fractures of the fifth metatarsal.
  
  
  METHODS
  The study group consisted of 50 consecutive athletes with a diagnosis of fifth metatarsal stress fracture and a control group matched for sport type and age. Fifth metatarsophalangeal (MTP-5) angle, fourth-fifth intermetatarsal (IMA4-5) angle, fifth metatarsal lateral deviation (MT5-LD) angle were measured on standing antero-posterior (AP) radiographs. Talo first metatarsal (T-MT1) angle, talo-calcaneal (TC) angle, and calcaneal pitch (CP) angle were measured on a standing lateral view, and MT5-LD angle was measured on a 30-degree medial oblique view.
  
  
  RESULTS
  Significant inter-group differences were found for TC angle (p < 0.001) and calcaneal pitch angle (p < 0.001) on lateral radiographs, and for IMA4-5 angle (p = 0.003), MT5-LD angle (p = 0.002) on AP radiographs, and for MT5-LD angle (p < 0.001) on the 30-degree medial oblique radiographs.
  
  
  CONCLUSIONS
  Fifth metatarsal stress fractures were found to be associated with elevated T-MT1 angle and CP angle representing a cavus foot and the increased curvature of fifth metatarsal. In addition, the extent of fifth metatarsal curvature on a 30-degree medial oblique view was found to be more related to the risk of fracture than on the AP view.
authors: Orthopaedic Hospital, Seoul, Korea.
authors: Kyung Tai
authors: KT
authors: Lee
authors: Ki Chun
authors: KC
authors: Kim
authors: Young Uk
authors: YU
authors: Park
authors: Tae Won
authors: TW
authors: Kim
authors: Young Koo
authors: YK
authors: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D002111:Calcaneus / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D005528:Foot / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D015775:Fractures, Stress / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000293:injuries*; D011859:Radiography; D012916:Soccer / Q000293:injuries*; D055815:Young Adult