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At least 19 recordsLinked to original sources
PubMedDate not supplied

Management of trauma to the fifth metatarsal bone.

The fifth metatarsal bone is a complex kinesiologic entity. It serves as the attachment of several soft tissue structures, and undergoes a distinctive range of motion. The lateral pedal location predisposes this bone to various reactive forces, and subsequent pathologic conditions. Anatomic and biomechanical review, with classification of fifth metatarsal injuries, and treatment recommendations, are discussed in the following manuscript.

Fracture Fixation, Internal↗
PubMed1987

Compression bone plating of a medial condylar fracture of the third metatarsal bone in a Thoroughbred filly.

A medial condylar fracture of the third metatarsal bone in a 2-year-old Thoroughbred filly was repaired successfully by use of compression bone plating. At discharge from the hospital, thickening of the metatarsus was evident, and proliferative changes were associated with the site of bone plate application. It was expected that these changes would limit the filly's use as a racehorse, and a return to training was not recommended. Especially in horses that may return to racing, use of compression bone plating initially should not replace stall rest or lag screw fixation treatment of this type of injury. However, the use of a similar approach in selected cases of medial condylar fracture of the third metatarsal bone is encouraged, especially when additional fissure lines are evident on radiographs.

Animals↗
PubMed1998

Longitudinal fractures of the condyles of the third metacarpal and metatarsal bones in racehorses: 224 cases (1986-1995).

OBJECTIVE: To determine type, distribution, and radiographic appearance of condylar fractures of the third metacarpal bone (MC-3) or third metatarsal bone (MT-3) in Thoroughbreds (TB), Standardbreds (SB), and Arabians, to assess long-term outcome of horses in which fractures were repaired surgically, and to identify variables associated with prognosis for return to racing. DESIGN: Retrospective study. ANIMALS: 224 horses with 233 fractures. PROCEDURE: Medical records and radiographs obtained before and after treatment were reviewed. Racing performance before and after treatment was determined by reviewing race records. RESULTS: TB were overrepresented and SB were underrepresented, compared with the hospital population. Thoroughbreds had significantly more lateral condylar fractures and significantly more forelimb fractures than did SB. Thoroughbreds were less likely to race after treatment if they had complete, rather than incomplete, lateral condylar fracture or had concurrent proximal sesamoid bone fracture. Convalescent time for TB with medial condylar fractures of MT-3 was significantly longer than that for TB with lateral condylar fractures of MT-3. CLINICAL IMPLICATIONS: Horses with condylar fractures of MC-3 and MT-3 that had minimal pathologic changes in the involved joint had a favorable prognosis for returning to racing after surgical treatment. Prognosis for horses with complete condylar fractures, particularly those with substantial pathologic changes in the involved joint, was worse.

Animals↗
PubMed1998

[Microsurgical treatment of ischemic necrosis of the head of the 2nd metatarsal bone].

In order to explore a new method to treat the ischemic necrosis of the head of 2nd metatarsal bone in adult, transposition of reversed vascularized metatarsal bone graft was adopted in the treatment of 4 cases, 2 of which were followed up for one and a half years. The postoperative X-ray showed the round head of the 2nd metatarsal bone became round and even density. The clinical observation showed that there was excellent function of metatarsophalangeal joint. It was concluded that the reversed vascularized metatarsal bone graft could provide a reliable blood supply and various osteogenic factors to the avascularized head of the metatarsal bone, and the operation could also debride the joint cavity and carry out decompression.

Adult↗
PubMed2004

Segmental ostectomy of the second and fourth metacarpal and metatarsal bones in horses: 17 cases (1993-2002).

OBJECTIVE: To determine clinical findings in and outcome of horses with fractures of the second or fourth metacarpal or metatarsal bone that underwent segmental ostectomy, leaving the proximal and distal portions of the bone undisturbed. DESIGN: Retrospective case series. ANIMALS: 17 horses. PROCEDURES: Medical records were reviewed, and information on signalment, affected bone, lesion type, surgical procedure, amount of bone removed, and surgical and postsurgical complications was obtained. Follow-up information was obtained through telephone conversations with owners, trainers, and referring veterinarians. RESULTS: One horse had a fracture involving the distal third of the second metacarpal bone; 13 had fractures involving the middle third of the second metacarpal bone (n = 4), fourth metacarpal bone (5), or fourth metatarsal bone (4); and 3 had fractures involving the proximal third of the second (2) or fourth (1) metacarpal bone. Affected portions of the bones were surgically resected, leaving the proximal and distal portions undisturbed. All horses returned to previous performance levels without evidence of lameness. Cosmetic results were good to excellent. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that horses with a complicated injury of the proximal, middle, or distal portion of the second or fourth metacarpal or metatarsal bone may be successfully treated by means of segmental ostectomy of the abnormal portion of the bone.

Animals↗
PubMed2006

First metatarsal bone: an anatomic study.

BACKGROUND: The purpose of this study was to establish the range of anatomic variations of the first metatarsal bone, including both the angulations of the articular surfaces and the dimensions of the bone in a large sample. METHODS: Four hundred and seventy-eight first metatarsal bones of 239 cadaver specimens were studied. The following parameters were recorded: the distal metatarsal articular angle (DMAA), distal metatarsal articular surface shape, proximal metatarsal articular angle (PMAA), the first metatarsal bone length and width at the mid-region of the shaft, and the existence of a joint between the bases of the first and second metatarsals. These parameters were correlated to the specimen's age, sex, race, height, and weight. The DMAA and PMAA were measured from a digital picture of the first metatarsal bone by a specially designed computer analysis program. RESULTS: Males and African-American race had a longer and wider metatarsal. The joint between the first and second bases was present in 25% of the population. The DMAA ranged from -14 degrees of medial deviation to 30 degrees of lateral deviation with an overall average of 8.21 degrees. The DMAA increased 1 to 3 degrees with every 10 years in age for both right and left bones with a p value of < 0.01 and < 0.001, respectively, and the average increase from 20 to 60 years of age was 4.5 degrees. The PMAA ranged from -13.8 degrees of lateral deviation to 12.7 degrees of medial deviation with an overall average of -1 degrees. PMAA significantly deviated laterally in the presence of a joint between the bases of the first and second metatarsals (p < 0.001). The male and female means for the DMAA and PMAA were nearly equal. CONCLUSIONS: The DMAA had a wider range than reported in the literature, and it increased with age. The first-second metatarsal joint was accompanied by lateral deviation of the PMAA. CLINICAL RELEVANCE: Laterally deviated PMAA could predispose to a varus deformity of the first metatarsal.

Adult↗
PubMed2005

Musculoskeletal responses of 2-year-old Thoroughbred horses to early training. 6. Bone parameters in the third metacarpal and third metatarsal bones.

AIM: To determine the effect of a known training regimen on the size and mineral content of the third metacarpal (Mc3) and third metatarsal (Mt3) bones of 2-year-old Thoroughbred horses trained on racetracks. METHODS: Mc3 and Mt3 of seven horses trained on grass and sand tracks were scanned at several sites using conventional quantitative and peripheral computed tomography (CT). Bone dimensions and density in the diaphysis and epiphysis were compared with those from seven untrained horses. Calcein label was injected in two clusters, during Weeks 9 and 12. The extent and rate of diaphyseal modelling was determined by confocal fluorescent microscopic examination of thin plane parallel sections of the mid-metacarpal region. RESULTS: Volumetric bone mineral density (BMDv) of the epiphysis was markedly higher and of the diaphysis was slightly higher in trained compared with untrained horses, but greater bone size in the trained horses had the greatest effect on an index of bone strength. Active osteons, defined as Haversian systems containing calcein label, were fewer, of smaller diameter at the time of calcein injection, and had a greater bone apposition rate in trained than in untrained horses. CONCLUSIONS: Conventional training of 2-year-old Thoroughbred racehorses over a 13-week period had a significant effect on bone size, density and strength index when compared to untrained horses. CLINICAL RELEVANCE: Bone responded rapidly to early training. The data provide reference values and sites for use in longitudinal studies of commercial training regimens.

Animals↗
PubMed1988

A case of short metatarsal bones lengthened by callus distraction.

Bilateral congenitally short fourth metatarsal bones were osteotomized subperiosteally, held in neutral position for 3 weeks by a small external fixator, and then subjected to slow axial distraction (0.25 mm/12h). The overall treatment time was 11 weeks, and the final increase in length was 14 mm for the left and 12 mm for the right metatarsal bone.

Adolescent↗
PubMedDate not supplied

The use of metatarsal bone grafts in the treatment of saddle nose deformities.

The results from segmental fourth metatarsal bone reconstruction of significant nasal dorsal defects are described. Solid bone graft reconstructions frequently lead to an unnatural hardness of the nasal tip. Rib cartilage reconstructions are pliable and soft, but pose a problem because they easily undergo warpage. The operation is performed using the open approach. An outer fourth metatarsal bone graft used for the bone component extends at least two-thirds of the dorsum length. It is secured in place with a compression screw and a Kirschner wire. The cartilage component comprises an abbreviated L-strut constructed of septal cartilage. It is slotted into the metatarsal bone in a tongue-in-groove manner and sutured to it through a drill hole in the bone. The dorsal profile is completed in this manner.

Adult↗
PubMed2003

Fractures of proximal portion of fifth metatarsal bone: anatomic and imaging evidence of a pathogenesis of avulsion of the plantar aponeurosis and the short peroneal muscle tendon.

PURPOSE: To evaluate the normal anatomy of the structures supporting the proximal portion of the fifth metatarsal bone and investigate the pathogenesis of fractures in this region. MATERIALS AND METHODS: In two cadaveric feet, the region of the lateral component of the plantar aponeurosis (PAL), short peroneal muscle (SPM) tendon, and third peroneal muscle (TPM) tendon was dissected. These two foot specimens and four nondissected foot specimens were studied at magnetic resonance (MR) imaging. Two of the six specimens were studied at computed tomography (CT). Sectioning the nondissected foot specimens enabled anatomic correlation. In two additional specimens, simulation of the presumed mechanism of fifth metatarsal bone fracture was attempted. The radiographic, CT, and MR images obtained in 13 patients with fractures of the proximal portion of the fifth metatarsal bone were evaluated. RESULTS: Anatomic, CT, and MR imaging studies revealed broad insertion of the PAL into the plantar aspect of the proximal portion of the fifth metatarsal bone in all specimens. The SPM tendon was consistently attached more distally and to the lateral side of the tuberosity, blending with the PAL fibers. The TPM tendon was inconsistently identified inserting anteriorly to the SPM tendon. No fracture was created in the specimens subjected to attempted injury. Frequent attachment of the PAL and the SPM tendon to the avulsed fragment was confirmed in clinical cases. CONCLUSION: The pathogenesis of fractures of the proximal portion of the fifth metatarsal bone appears to be related to avulsion injury of PAL and SPM tendon fibers.

Adult↗
PubMed1988

Intra-osseous pressure of the equine third metatarsal bone.

Intra-osseous pressure was measured in the third metatarsal bone of 8 pony foals at the age of 1, 3, 6 and 26 weeks of age, and on one occasion in the third metatarsal bone of 5 ponies aged 1-5 years; the animals were under general anesthesia and in lateral recumbency. Saphenous venous pressure and lateral superficial plantar metatarsal arterial pressure were also monitored throughout the procedure. There were no statistically significant changes in the epiphyseal, diaphyseal, venous or arterial pressures with increasing age of the foals. There was no statistically significant difference between the mean epiphyseal and mean diaphyseal pressures in the foals. Individually however, the diaphyseal pressure exceeded the epiphyseal pressure in 32 of the 36 measurements made in the foals. Saphenous vein occlusion and intravenous adrenalin administration showed that both venous and arterial pressures influence intra-osseous pressure. Intra-osseous injection of heparinized saline on one side of the growth plate produced an immediate massive increase in intra-osseous pressure on that side of the growth plate, but in almost all cases a concomitant rise in intraosseous pressure on the other side of the physis did not occur. Simulated effusion of the metatarsophalangeal joint was associated with an increase in intraosseous pressure in the adjacent metatarsal epiphysis, and flexion of the joint with an increase in intraosseous pressure in both the epiphysis and the metaphysis.

Aging↗
PubMed1999

Stress fractures of the lateral metatarsal bones in metatarsus adductus foot deformity: a previously unrecognized association.

OBJECTIVE: To document a distinctive pattern of stress fractures in the lateral metatarsal bones of patients with metatarsus adductus foot deformity. DESIGN AND PATIENTS: Conventional radiographs and available medical records were reviewed in 11 patients (6 women, 5 men; ages 25-61 years) with stress fractures of the lateral (fourth or fifth) metatarsal bones and metatarsus adductus. Evaluation included the number and location of fracture(s), forefoot adduction angle, and qualitative assessment of bone mineral density. Conditions that might predispose patients to metatarsal fractures, including direct trauma, osteoporosis, and neuropathic osteoarthropathy were also recorded. RESULTS: A total of 22 stress fractures were demonstrated, 17 of which involved the lateral metatarsals. A solitary fracture was present in six patients, while multiple fractures were evident in five patients. The sites of involvement were the fifth metatarsal (n=10), fourth metatarsal (n=7), third metatarsal (n=3), second metatarsal (n=1), and first metatarsal (n=1) bones. The locations of the stress fractures were in the proximal one-third of the metatarsal bones in 19 instances (86%) and in the middle one-third in three instances (14%). Forefoot adduction angle measured between 21 degrees and 37 degrees (normal range 8 degrees -14 degrees). CONCLUSION: Patients with metatarsus adductus may be at increased risk for stress fractures involving the lateral metatarsal bones, likely owing to the presence of altered biomechanics that place greater loads across the lateral aspect of the foot.

Adult↗