Abstract
Design: Retrospective chart and radiographic review.
Background: Stress fractures of the fifth metatarsal are increasingly common among elite professional footballers (soccer players). This reflects the use of lighter, less protective and more flexible sports footwear combined with the increasingly physical demands of the professional game at the highest level. Stress fractures of the fifth metatarsal can be satisfactorily treated non-operatively by cast immobilisation and a graduated return to activity. The demands placed on the modern elite professional footballer are such that a different treatment approach is required for the same injury in this subgroup of patients.
Methods: Stress fractures of the fifth metatarsal in elite professional footballers are treated by the senior author (JPH) by operative surgical fixation. We reviewed the charts and radiographs of all fifth metatarsal stress fractures that were treated operatively in elite professional footballers over a five year period. Details recorded included fracture location, method of fixation, complications, time to radiological union and time to return to independent weightbearing and competitive sporting activity.
Results: There were 32 fifth metatarsal stress fractures in 30 elite professional footballers. All fractures were clinically united at a mean 5.5 weeks and radiologically united at a mean of 10.3 weeks. The patients could weightbear immediately and could independently weightbear from 4 weeks. The mean time to return to full competitive activity was 10.3 weeks. There were no complications.
Conclusions: Operative treatment of fifth metatarsal stress fractures is an effective treatment in elite professional footballers that produces consistently good results and allows an early return to full activity.
Correspondence should be addressed to: Mr Andrew H. N. Robinson, Editorial Secretary, Department of Trauma and Orthopaedics, BOX 37, Addenbrooke’s Hospital, Cambridge CB2 2QQ, England.
