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Fracture of the Second Metatarsal Base

An Overlooked Cause of Chronic Midfoot Pain

Gregory Morris, DPM^*, Kelly Nix, DPM and Flair D. Goldman, DPM^*

^* Division of Podiatric Surgery, Department of Orthopedics, Podiatry, and Sports Medicine, Kaiser Permanente Medical Center, Santa Clara, CA. Dr. Morris is currently in private practice, Honolulu, HI.
Division of Podiatry, Orthopedics Department, Kaiser Permanente Medical Center, Sacramento, CA. Currently in private practice, Los Gatos, CA.
Presented at the annual meeting of the American Podiatric Medical Association, August 11, 2000, Philadelphia, PA.

Corresponding author: Gregory Morris, DPM, Queens Physicians Office Bldg 2, 1329 Lusitana St, Ste 805, Honolulu, HI 96813.

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. (J Am Podiatr Med Assoc 93(1): 6-10, 2003)

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