Department of Orthopaedics Traumatology, Rehabilitation and Plastic Surgery, Second University of Naples, Via L. De Crecchio, 4, Naples, Italy 80138, Italy.
Foot Ankle Int. 2011 May;32(5):S526-32. doi: 10.3113/FAI.2011.0526.
Numerous studies document the high incidence of this type of fracture of the foot in childhood due to the presence of the growth plate of the apophysis of the fifth metatarsal. Our aim in this study was to evaluate the presence and morphology of the growth nucleus and correlate its presence with fractures of the apophysis of the fifth metatarsal.
Between 2001 and 2003, we reviewed the radiographs of 481 patients (558 feet) between 6 months and 16 years that were diagnosed with a fracture. We evaluated for the presence and morphology of the growth nucleus of the base of the fifth metatarsal in the 7- to 16-year age group because this is the time interval in which the nucleus becomes visible radiographically.
We identified the nucleus of the base of the fifth metatarsal in 115 patients for a total of 132 feet. A fracture of the fifth metatarsal was found in 12.8%. A misdiagnosis had been made in 47%. Misdiagnosis was strictly related to the presence of the growth nucleus of the apophysis except two cases where an accessory bone was present.
Our study demonstrated a much higher incidence of the presence of the growth nucleus than documented in previous reports and that its morphology varied widely in relation to the stage of maturity of the patient and the radiographic technique. Its presence led to a high rate of misdiagnosis of a fracture.
大量研究表明，儿童足部这种类型的骨折发生率很高，这是由于第五跖骨副骨的生长板的存在。我们在这项研究中的目的是评估生长核的存在和形态，并将其与第五跖骨副骨骨折相关联。
在 2001 年至 2003 年期间，我们回顾了 481 名患者（558 只脚）的 X 光片，这些患者的年龄在 6 个月至 16 岁之间，均被诊断为骨折。我们评估了 7 至 16 岁年龄组第五跖骨基底生长核的存在和形态，因为这是核在 X 线片上变得可见的时间间隔。
我们在 115 名患者中发现了第五跖骨基底核，共有 132 只脚。发现第五跖骨骨折的占 12.8%。误诊率为 47%。误诊与副骨生长核的存在密切相关，除了两个存在副骨的病例。
我们的研究表明，生长核的存在率远远高于以前的报道，其形态与患者的成熟阶段和 X 线技术密切相关，变化很大。它的存在导致了骨折的高误诊率。
