Korean J Sports Med.  2020 Mar;38(1):55-58. 10.5763/kjsm.2020.38.1.55.

Surgical Resection of Intermetatarsal Coalition of the Fourth and Fifth Founded in Long Distance Running

Affiliations
  • 1Department of Orthopaedic Surgery, Armed Forces Chuncheon Hospital, Chuncheon, Korea

Abstract

Intermetatarsal coalition (IC) is very rare; although few cases have been reported in foreign orthopedic journals, these have not originated in our country. We report the case of a 20-year-old man who complained of pain in the left forefoot only during long distance running (3 km). On examination, his foot shape, skin appearance, and gait were normal, with no plantar keratosis; however, the radiograph revealed coalition between the fourth and fifth metatarsals. Surgical excision was performed. In the histopathologic study, fibrous coalition was confirmed. This paper reports an uncommon case involving surgical excision of IC in the military service, involving active sport activity.

Keyword

Congenital; Metatarsal bones; Running; Surgery; Synostosis

Figure

  • Fig. 1. Anteroposterior foot standing radiograph reveals left foot 4th−5th intermetatarsal coalition, pedunculated bony mass at left medial cuneiform, right second metatarsal base, fifth metatarsal head.

  • Fig. 2. Coronal computed tomography of left foot demonstrating fibrous coalition of the 4th−5th Intermetatarsal.

  • Fig. 3. Intraoperative resection finding of coalition of left foot.

  • Fig. 4. Anteroposterior radiographic view of resected coalition of left foot on postoperative day.

  • Fig. 5. Bony bridge, low-power histopathologic image showing sections of mature lamellar bone (H&E, ×20).


Reference

References

1. Aspros D, Ananda-Rajan E, Jnr ZK, Rajan R. Distal metatarsal synostosis: a case report. Foot (Edinb). 2014; 24:153–6.
Article
2. Dunn KW, Giordano AR. Surgical resection of bilateral coalition of the third and fourth metatarsals: a case report. J Foot Ankle Surg. 2016; 55:1038–42.
Article
3. Russell N, Stavrou P, Dracopoulos G. Intermetatarsal coalition: a delayed complication of hallux valgus surgery. ANZ J Surg. 2014; 84:290–2.
Article
4. Vun SH, Drampalos E, Shareef S, Sinha S, Bramley D. Distal metatarsal coalition: a rare case report. Int J Surg Case Rep. 2015; 8:182–4.
Article
5. Cordoba-Fernandez A, Rayo-Rosado R, Lopez-Garcia D, Juarez-Jimenez JM. A rare intermetatarsal coalition with rigid fifth metatarsal deformity and symptomatic plantar lesion. J Foot Ankle Surg. 2016; 55:1091–6.
6. Kumai T, Takakura Y, Akiyama K, Higashiyama I, Tamai S. Histopathological study of nonosseous tarsal coalition. Foot Ankle Int. 1998; 19:525–31.
Article
7. Cass AD, Camasta CA. A review of tarsal coalition and pes planovalgus: clinical examination, diagnostic imaging, and surgical planning. J Foot Ankle Surg. 2010; 49:274–93.
Article
8. Jayakumar S, Cowell HR. Rigid flatfoot. Clin Orthop Relat Res. 1977; 122:77–84.
Article
Full Text Links
  • KJSM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr