Metatarsal fracture mechanism: accelerating loads the fifth ray more than cutting

Introduction Metatarsal fractures, especially of the 5th metatarsal are an increasingly common orthopedic problem among athletes [1]. Sports with a substantial amount of sprint and cutting movements appear to be at greater risk for both stress and acute fractures of the fifth metatarsal. One mechanism of injury is proposed to be the cumulative effect of the many bending moments applied to the fifth ray during cutting maneuvers, specifically to the foot on the inside of the turn [2]. This hypothesis has been bolstered by observing several athletes fracturing their 5th metatarsal during cutting maneuvers in games recorded on video, but no rigorous evidence exists to support cutting as the cause of the fracture. The purpose of this study was to identify the loading pattern of the fifth metatarsal during several typical sport maneuvers to determine if a bending moment is likely to occur.