Metatarsal march (fatigue) fractures

Abstract

1. 1. Metatarsal march fracture is primarily an occupational disease of soldiers. 2. 2. The author believes that metatarsal march fractures are caused by fatigue of the peroneus longus and tibialis posticus muscles. 3. 3. March fractures are more properly termed fatigue fractures. There is no basis for the belief, as some authors have indicated, that metatarsal march fractures are due to spasm and overactivity of the interossei muscles. 4. 4. The presence of an atavistic foot as an etiological factor of metatarsal march fracture is greatly over-rated. 5. 5. All of the metatarsal march fractures in this series which were investigated occurred in soldiers with normal feet, or in cases of slight degree of pes planus and in cases of pes cavus. Not a single case of severe pes planus was encountered. 6. 6. Pre-induction occupation of the soldier does not appear to be a decisive element except insofar as the tolerance of fatigue may be concerned. 7. 7. The thinness of the metatarsal bone plays no important rôle in the etiology of metatarsal fractures as more fractures occurred in metatarsal bones other than the thinnest. 8. 8. All age groups from eighteen to thirty-eight were involved in metatarsal march fractures but the eighteen and nineteen year old group were chiefly affected. 9. 9. March fractures of the metatarsals involved all bones of the metatarsal segment but chiefly the second and third of the right foot. 10. 10. Twenty-three cases of multiple metatarsal march fractures were encountered. 11. 11. Fractures of the metatarsal bone involved 2.35 per cent of 10,953 cases seen by the Orthopedic Surgical Section at our Station Hospital.