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Anatomical variations: Differences in metatarsal length or shape may predispose individuals to the condition. A relatively long second metatarsal, for example, may be subject to increased mechanical stress. Hormonal influences: The higher prevalence in females, particularly during adolescence, suggests a possible hormonal component.
In runners, march fracture occurs most often in the metatarsal neck, while in dancers it occurs in the proximal shaft. In ballet dancers, fracture mostly occurs at the base of the second metatarsal and at Lisfranc joints. This fracture always occurs following a prolonged stress or weight bearing, and the history of direct trauma is very rare.
As the bones now experience larger stresses, this increases the risk of fracture. Previous stress fractures have been identified as a risk factor. [6] Along with history of stress fractures, a narrow tibial shaft, high degree of hip external rotation, osteopenia, osteoporosis, and pes cavus are common predisposing factors for stress fractures. [3]
A Lisfranc injury, also known as Lisfranc fracture, is an injury of the foot in which one or more of the metatarsal bones are displaced from the tarsus. [1] [2]The injury is named after Jacques Lisfranc de St. Martin, a French surgeon and gynecologist who noticed this fracture pattern amongst cavalrymen in 1815, after the War of the Sixth Coalition.
intra articular comminuted fracture of base of first metacarpal: axial load along the metacarpal causing splitting of the proximal articular surface: Rolando's fracture at Wheeless' Textbook of Orthopaedics online Runner's fracture: Running: stress fracture of distal fibula 3–8 cm above the lateral malleolus: repeated axial stress on fibula
Lisfranc fracture, with an increased distance between the medial cuneiform and the second metatarsal. The Lisfranc ligament connects the medial cuneiform bone to the second metatarsal. [2] It is a complex of 3 ligaments: the dorsal Lisfranc ligament, the interosseous Lisfranc ligament, and the plantar Lisfranc ligament. [2] [3]
3. Keebler Fudge Magic Middles. Neither the chocolate fudge cream inside a shortbread cookie nor versions with peanut butter or chocolate chip crusts survived.
The synovial membrane between the second and third cuneiforms behind, and the second and third metatarsal bones in front, is part of the great tarsal synovial membrane. Two prolongations are sent forward from it, one between the adjacent sides of the second and third, and another between those of the third and fourth metatarsal bones.