A soldier with a complain of long term standing,presets with a complain of cramp-like pain in the forefoot, and moderate local edema on the dorsal aspect,when the shoes are taken off.
X ray shows the following features.What can be the most possible diagnosis?
A. Turf Toe
C. Stress Fracture
D. Jone’s Fracture
Ans:C. Stress Fracture.
- March fracture, also known as fatigue fracture or stress fracture of metatarsal bone, is the fracture of the distal third of one of the metatarsals occurring because of recurrent stress.
- It is more common in soldiers, but also occurs in hikers, organists, and even those, like hospital doctors, whose duties entail much standing.
- March fractures most commonly occur in the second and third metatarsal bones of the foot.
- It is a common cause of foot pain, especially when people suddenly increase their activities.
- When the boot or shoes are taken off, there is a cramp-like pain in the affected forefoot, and moderate local edema appears on the dorsal aspect. On moving each toe in turn, that of the involved metatarsal causes pain, and when the bone is palpated from the dorsal surface, a point of tenderness is found directly over the lesion.
- The first line treatment should be reduction of movements for 6 to 12 weeks. Wooden-soled shoes or a cast should be given for this purpose.