Description
The metatarsals as a unit in the forefoot provide a broad plantar (on the sole) surface for load sharing. They are mobile in the sagittal plane (up and down) and individually the metatarsal heads can alter position to cope with uneven ground. This even sharing of weight also protects the skin from injury. Metatarsal fractures are usually caused by the blow of a heavy object dropped onto the forefoot or by a twisting injury. Fractures of the shaft can be caused by twisting of the body with the toes fixed, applying torque to the foot. Avulsion (pull-off) fractures occur particularly at the base of the 5th metatarsal.
Stress fractures are common in the second and third metatarsal necks and at the proximal portion of the shaft of the fifth metatarsal. Athletes and soldiers seem to be more prone to this type of injury. A prospective study of 205 soldiers by Milgrom et al(14) showed 184 stress fractures of the lower extremity, 7.6% of which were of the metatarsals. Up to 20% (11% 2nd metatarsal) of stress fractures in athletes and 23% in military recruits are located in the metatarsals (9,12,13).
Source: http://www.sportsinjurybulletin.com/archive/metatarsal-fractures.html
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