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THE RISK FACTORS OF 5TH METATARSAL STRESS FRACTURE IN FOOTBALL PLAYERS
  1. Sho Matsuda1,
  2. Norikazu Hirose2,
  3. Toru Fukubayashi2
  1. 1Graduate School of Sport Sciences, Waseda University, Saitama, Japan
  2. 2Faculty of Sport Sciences, Waseda University, Saitama, Japan

    Abstract

    Background No firm consensus has been established regarding the risk factors for stress fracture of the 5th metatarsal because of a lack of large-scale prospective studies.

    Objective The purpose of this study was to clarify the risk factors for a stress fracture of the 5th metatarsal.

    Design Cohort study.

    Setting Prospective study with well-trained varsity players.

    Participants One hundred and sixty healthy collegiate male football (soccer) players.

    Assessment of Risk Factors The medial lateral arch ratio of the foot, leg-heel alignment with weight-bearing (WLHA), LHA without weight-bearing (NLHA), relative angle of the forefoot to the hindfoot (FA-H), and plantar pressure during the heel raise position were measured. Rearfoot and forefoot alignment were evaluated from images using Image J. The plantar pressure distribution was measured using a plate-type lower limb GP-6000 weighted meter and pressure distribution-measuring MD-1000 device from Anima Co., Ltd.

    Main Outcome Measurements The measurements from players who were diagnosed with a stress fracture of the 5th metatarsal were compared with the measurements from non-injured players.

    Results Four players were diagnosed with a stress fracture of the 5th metatarsal. The arch ratio, WLHA, and FA-R of the injured players were higher than those of the non-injured players (17.8±0.21 vs. 1.68±0.26, −3.79±2.5° vs. −4.24±2.93°, 4.34±3.62° vs. 3.19±5.18°). The NLHA of the injured players was lower than that of the non-injured players (3.08±2.29° vs. 6.03±4.51°). The plantar pressure of the injured players tended to be located in a more lateral position compared with the non-injured players during heel raise (55.41±1.59% vs. 47.93±4.59%).

    Conclusions Stress on the lateral side of the foot during heel raise may cause stress fractures of the 5th metatarsal.

    • Injury

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