Metatarsal insufficiency fractures in previously undiagnosed osteoporosis patients.

This paper, along with a review of osteoporosis, examines 21 patients (15 women and 6 men) who presented to the senior author between May 1997 and January 1999 with unexplained metatarsal fractures. All 21 patients agreed to bone density testing. Twenty of the 21 had bone densities significantly below the mean for corresponding age, gender, and race. The average bone density for the 21 patients was 2.1 standard deviations below the expected mean for the corresponding 30-year-old reference population and 1.7 standard deviations below the mean for an age, gender, weight, and ethnicity matched population. Distribution and location of the fractures were also investigated. The Body Mass Indices were calculated for all 21 patients, but did not seem to play a role in the fractures. Pertinent medical histories and possible factors for comorbidity are also presented. In all cases successful treatment consisted of guarded weightbearing in a padded boot. The authors conclude that there is a previously unreported correlation between metatarsal insufficiency fractures and low bone mass in both genders, confirmed by the abnormal bone mineral density testing. They also point out that men should be made aware that they can suffer from this disease.