Can body mass index influence the fracture zone in the fifth metatarsal base? A retrospective review

Fifth metatarsal base fracture are common in routine orthopaedic practice [1–6]. Lawrence and Botte [7] pro- posed a classification based upon the position of the fracture line (zone 1: tuberosity, zone 2: meta-diaphyseal junction, zone 3: proximal diaphysis). Pathomechani- cally, injury patterns develop in different ways: in zone 1, a traction injury caused by peroneus brevis tendon and the lateral band of the plantar fascia determine an avul- sion fracture of the tuberosity, also called “pseudo-Jones’ “fracture; in zone 2, forced foot adduction and excessive plantar flexion determine a fracture in the metaphyseal- diaphyseal junction, also called Jones’ fracture [8, 9]; in zone 3, acute over-bearing onto the area or chronic overload determine a fracture in the proximal portion of the diaphysis, distal to the intermetatarsal joint [10, 11]. To the best of the Authors’ knowledge, no study has been published to date on the relationship between the value of Body Mass Index (BMI) and the prevalence of fractures in a specific portion of the fifth metatarsal base. The aim of this study was to define the impact of BMI on fifth metatarsal base fractures location according to Lawrence and Botte classification [7].