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Stress Frx of Forefoot & Midfoot



- Midfoot Fatigue Fractures:
    - fatigue frx are rare in midfoot (of these frx in navicular are most common);
    - radiographs & bone scan are necessary to make the diagnosis;
    - treatment involves eliminating athletic activity until healing is complete, which often takes several months;

- Metatarsal Stress Frx:

- Stress Frx Ballet Dancers:
    - common sites for stress frx include second and third metatarsals, sesamoids, and distal fibula;
    - ballet dancers had most of pain in full en pointe position, where wt is concentrated on the first and second toes;
          - 2nd & 3rd metatarsals, are relatively immobile when compared w/ 1st, 4th, and 5th metatarsal rays & are more prone to frx;
    - frx also occur frequently in the navicular



Tarsal navicular stress fractures in runners.
  
Stress fractures of the second metatarsal involving Lisfranc's joint in ballet dancers. A new overuse injury of the foot.

Strain and loading of the second metatarsal during heel-lift.