A study of metatarsal fractures in children.

BACKGROUND: Metatarsal fractures are common in children. The aim of the present study was to analyze a consecutive series of metatarsal fractures in children and to describe the epidemiology of the fractures, the location of the fractures, and the mechanism of injury.

METHODS: A consecutive series of 125 patients with metatarsal fractures who presented to one pediatric surgery department over a twenty-two-month period was evaluated with use of a questionnaire to define the mechanism of injury. All patients were followed until the fracture was healed. The specific location of the fractures and the mechanism of injury were identified.

RESULTS: One hundred and twenty-five children (seventy-five boys and fifty girls; average age, 8.6 years [range, one to seventeen years]) presented with 166 metatarsal fractures. Major differences were found between children who were five years of age or less and those who were more than five years of age. In patients who were five years of age or less, the predominant location of the accident that had caused the fracture was inside the house and the primary mechanism was a fall from a height. In patients who were more than five years of age, most accidents occurred at sports facilities and were caused by a fall on a level surface. The most frequently fractured metatarsal in younger children was the first, whereas the most frequently fractured metatarsal in older children was the fifth.

CONCLUSIONS: The mechanism of injury and clinical presentation of metatarsal fractures in children are age-dependent, with patients five years of age or less and those more than five years of age having different mechanisms of injury and different types of metatarsal fractures.