Nutrition and the incidence of stress fractures in ballet dancers

N T Frusztajer; S Dhuper; M P Warren; J Brooks-Gunn; R P Fox

doi:10.1093/ajcn/51.5.779

Atypical Stress-Avulsion Fracture of the Lisfranc Joint Complex

Foot & Ankle Specialist ◽

10.1177/1938640014521832 ◽

2014 ◽

Vol 7 (2) ◽

pp. 155-158 ◽

Cited By ~ 3

Author(s):

Barry J. O’Neill ◽

Laura A. Sweeney ◽

Paul J. Moroney ◽

Kevin J. Mulhall

Keyword(s):

Case Report ◽

Antiphospholipid Syndrome ◽

Avulsion Fracture ◽

Stress Fractures ◽

Therapeutic Level ◽

Lisfranc Joint ◽

Level Of Evidence ◽

Ballet Dancers ◽

Metatarsal Fractures ◽

Unusual Injury

Antiphospholipid syndrome and systemic erythematosus have been associated with metatarsal stress fractures. Stress fractures of the Lisfranc joint complex are uncommon injuries but have been reported to occur most frequently in ballet dancers. We present a case of an avulsion fracture of the Lisfranc joint complex that occurred spontaneously. We have reviewed the association between systemic conditions and metatarsal fractures and proposed a series of hypothetical pathological events that may have contributed to this unusual injury. Level of Evidence: Therapeutic, Level IV: Case report

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Stress Fractures at the Base of the Second Metatarsal in Ballet Dancers

Foot & Ankle International ◽

10.1177/107110079601700206 ◽

1996 ◽

Vol 17 (2) ◽

pp. 89-94 ◽

Cited By ~ 61

Author(s):

Martin J. O'Malley ◽

William G. Hamilton ◽

John Munyak ◽

Michael J. DeFranco

Keyword(s):

Risk Factors ◽

Stress Fracture ◽

Symptomatic Treatment ◽

Senior Author ◽

Stress Fractures ◽

Ballet Dancers ◽

Persistent Symptoms ◽

Common Location ◽

Second Metatarsal ◽

Delayed Menarche

Stress fractures are a frequent injury in ballet companies and the most common location is at the base of the second metatarsal. While previous reports have focused on risk factors for this injury (overtraining, delayed menarche, poor nutrition), there is no published series describing the natural history and outcome following this fracture. We reviewed the office records of the senior author and identified 51 professional dancers (64 fractures) who sustained a stress fracture at the base of the second metatarsal. History of a previous stress fracture in the lower extremity was seen in 19 patients and delayed menarche in the women was common. The clinical presentation was insidious onset of midfoot pain an average of 2.5 weeks prior to seeking medical care. The initial radiographs of the foot were positive in 19 patients, questionable in 3 patients, and negative in 42 patients. The usual location of the fracture was at the proximal metaphyseal-diaphyseal junction (three fractures extended into the tarsometatarsal joint). Treatment consisted of a short leg walking cast for 6 patients, and a wooden shoe and symptomatic treatment for the remainder. At follow-up, 14% of patients still had occasional pain or stiffness in the midfoot with dancing. The patients returned to performance at an average of 6.2 weeks following diagnosis. No patients required bone grafting for persistent symptoms. There were eight refractures (at the same site) occurring an average of 4.3 years, all of which healed with conservative care. Stress fractures at the base of the second metatarsal are common in ballet dancers and can usually be treated with symptomatically. The results of this study are discussed in terms of risk factors, the use of a posterior-anterior view of the foot to eliminate overlap at Lisfranc's joint, and our present treatment regimen.

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Stress fractures in ballet dancers

The American Journal of Sports Medicine ◽

10.1177/036354659202000414 ◽

1992 ◽

Vol 20 (4) ◽

pp. 445-449 ◽

Cited By ~ 122

Author(s):

Nancy J. Kadel ◽

Carol C. Teitz ◽

Richard A. Kronmal

Keyword(s):

Stress Fractures ◽

Ballet Dancers

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Stress fractures of the base of the metatarsal bones in young trainee ballet dancers

International Orthopaedics ◽

10.1007/s00264-009-0784-3 ◽

2009 ◽

Vol 34 (1) ◽

pp. 51-55 ◽

Cited By ~ 33

Author(s):

Walter Albisetti ◽

Dario Perugia ◽

Omar De Bartolomeo ◽

Lorenzo Tagliabue ◽

Emanuela Camerucci ◽

...

Keyword(s):

Stress Fractures ◽

Ballet Dancers ◽

Metatarsal Bones

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Multiple Simultaneous Metatarsal Stress Fractures in the Same Foot

Journal of the American Podiatric Medical Association ◽

10.7547/0003-0538-105.2.177 ◽

2015 ◽

Vol 105 (2) ◽

pp. 177-180 ◽

Cited By ~ 1

Author(s):

Murat Mert ◽

Ethem Ayhan Unkar ◽

Ali Volkan Ozluk ◽

Tolga Tuzuner ◽

Sinan Erdoğan

Keyword(s):

Case Report ◽

Stress Fractures ◽

Demographic Characteristics ◽

Overuse Injuries ◽

Ballet Dancers ◽

Military Recruits ◽

Poor Outcomes

Metatarsal stress fractures are common overuse injuries in athletes, military recruits, and ballet dancers, usually occurring in the second, third, and fourth metatarsals, respectively. Such fractures may also occur in a variety of other individuals, regardless of demographic characteristics, sex, or profession, and they are highly associated with excessive activity. Moreover, these types of fractures are usually diagnosed late and have poor outcomes. To our knowledge, there has been only one case report of an individual with stress fractures of all three central metatarsals in the same foot. We describe herein a racehorse training jockey who presented with multiple simultaneous metatarsal stress fractures in the same foot. We also discuss the possible mechanisms by which this entity occurred, as well as its management and outcome.

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