Outcomes of Surgically Treated Fifth Metatarsal Fractures in Major League Soccer Athletes

Abstract

Background: Sports-related fractures of the fifth metatarsal are common in professional athletes. Data regarding outcomes of surgical management including refracture, complications, and return-to-play statistics are available for other professional American sports with a notable exception of soccer. Purpose: To quantify the burden of operative fifth metatarsal fractures in Major League Soccer (MLS) athletes, to compare outcomes as well as refracture and complication rates with other professional sports, to analyze factors that may contribute to treatment failure, and to report on return-to-play characteristics for affected players. Study Design: Case series; Level of evidence, 4. Methods: We searched all injuries in the prospectively collected HealtheAthlete database for MLS for operative fifth metatarsal fractures for seasons 2013 to 2017. Additional information regarding each fracture including demographics, treatment, postoperative course, and return-to-play statistics were compiled from HealtheAthlete and supplemented by teams’ chief medical officers, coaches, trainers, and online sources. Results: There were 21 fractures in 18 players during the study period. Mean time to radiographic healing was 8.5 weeks (n = 17). Mean time to return to play was 11.1 weeks (n = 19). Of 21 fractures, 20 (95%) players returned to sport. Of 18 players, 4 (22.2%) experienced refracture. Of 18 players, 5 (27.8%) and 2 (11.1%) reported previous stress injuries on the contralateral and ipsilateral limb, respectively. Player performance characteristics showed small declines in the first year of return that improved by the second year. Conclusion: MLS athletes who sustain a sports-related fifth metatarsal fracture can expect a high rate of return to sport with time to radiographic healing and return to play as well as risk of refracture similar to other professional cohorts.

Characteristics of Plantar Pressure with Foot Postures and Lower Limb Pain Profiles in Taiwanese College Elite Rugby League Athletes

“…Muscle fatigue in footballers is believed to be at the core of developing metatarsal stress fractures because of the increased load on the forefoot of runners in a state of fatigue [6]. Proximal fifth metatarsal fractures, commonly referred to a 'Jones Fracture', is a common podiatric disease in basketball [7] and soccer [8] players, and usually occurs when the proximal fifth metatarsal suffers from the forces caused by the specific repetitious jumping and cutting [8,9].…”

Auditing the Representation of Female Athletes in Sports Medicine Research: Fifth-Metatarsal Fractures

“…Most of the world-class, international, elite, and national athlete studies were male only, or included predominantly male patients. 1,7,21,24,25,38,[43][44][45] A potential limitation of this study is the lack of focus on incidence rates of fifth-metatarsal fractures between males and females in the literature. It is possible that female athletes experience different rates of fifth-metatarsal fractures than men, which may influence their inclusion in the literature; however, this point was not discussed within the literature included in this study.…”

“…Most of the world-class, international, elite, and national athlete studies were male only, or included predominantly male patients. 1,7,21,24,25,38,43 -45…”

“…Within the 30 studies, 10 were male-only representing 33.33% (10 of 30) 1,[20][21][22]24,25,38,[43][44][45] ; 1 was female-only, representing 3.33% (1 of 30) 41 ; 1 had male-vs-female design features, representing 3.33% (1 of 30) 15 ; and 18 were mixed-sex cohorts, representing 60% (18 of 30). 2,3,7,8,18,19,23,26,27,[30][31][32][33][34]36,37,39,46 There was no male-vsfemale subanalysis available.…”

“…Twenty-six of 34 articles mention HR, NUR, DUR, RTS, and RFR, which are reported along with 4-year journal impact factor, and Altmetric score for each individual study (Table 1). 34 5.997 -50.00 0.00 50.00 --Pećina et al 36 5.997 -----100 Reese et al 37 5.997 -100 6.60 --100 Roberston et al 39 1.707 ------Shaffer et al 41 5.997 9 -----Spang et al 43 3.095 25 -----Stone et al 44 5.997 13 100 0.00 0.00 22.20 95.00 Watson et al 46 3.095 7 100 0.00 0.00 4.00 100…”