Forefoot Adduction Is a Risk Factor for Jones Fracture.

Autor: Fleischer AE; Director of Research, Weil Foot and Ankle Institute, Des Plaines, IL; Associate Professor, Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, IL. Electronic address: aef@weil4feet.com., Stack R; Fourth-Year Student, Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, IL., Klein EE; Associate Director of Research, Weil Foot and Ankle Institute, Des Plaines, IL; Instructor, Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, IL., Baker JR; Physician, Weil Foot and Ankle Institute, Des Plaines, IL., Weil L Jr; President, Weil Foot and Ankle Institute, Des Plaines, IL., Weil LS Sr; CEO, Weil Foot and Ankle Institute, Des Plaines, IL.
Jazyk: angličtina
Zdroj: The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons [J Foot Ankle Surg] 2017 Sep - Oct; Vol. 56 (5), pp. 917-921. Date of Electronic Publication: 2017 May 31.
DOI: 10.1053/j.jfas.2017.04.017
Abstrakt: Jones fractures are among the most common fractures of the foot; however, much remains unknown about their etiology. The purpose of the present study was to further examine the risk factors of forefoot and hindfoot alignment on Jones fractures using an epidemiologic study design. We used a retrospective, matched, case-control study design. Cases consisted of patients with acute, isolated Jones fractures confirmed on plain film radiographs seen at our institute from January 2009 to December 2013. Patients presenting with pain unrelated to metatarsal fractures served as controls. Controls were matched to cases by age (±2 years), gender, and year of presentation. Weightbearing foot radiographs were assessed for 13 angular relationships by a single rater. Conditional multivariable logistic regression was used to identify important risk factors. Fifty patients with acute Jones fractures and 200 controls were included. The only significant variables in the final multivariable model were the metatarsus adductus angle (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.08 to 1.25) and fourth/fifth intermetatarsal angle (OR 0.69, 95% CI 0.57 to 0.83)-both measures of static forefoot adduction. The presence of metatarsus adductus (defined as >15°) on foot radiographs was associated with a 2.4 times greater risk of a Jones fracture (adjusted OR 2.4, 95% CI 1.2 to 4.8). We have concluded that the risk of Jones fracture increases with an adducted forefoot posture. In our population, which consisted primarily of patients presenting after a fall (10 of 50; 20%) or misstep/inversion injury (19 of 50; 38%), the hindfoot alignment appeared to be a less important factor.
(Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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