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

Myung Guk Cho; Samuel Baek; Sun Geun Lee; Chungwon Bang

doi:10.5763/kjsm.2020.38.1.55

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Cho, Baek, Lee, and Bang: Surgical Resection of Intermetatarsal Coalition of the Fourth and Fifth Founded in Long Distance Running

Case Report

Korean J Sports Med 2020;38(1):55-58.

Published online: 20 January 2020

DOI: https://doi.org/10.5763/kjsm.2020.38.1.55

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

Myung Guk Cho, Samuel Baek, Sun Geun Lee, Chungwon Bang

Department of Orthopaedic Surgery, Armed Forces Chuncheon Hospital, Chuncheon, Korea

Correspondence: Myung Guk Cho Department of Orthopaedic Surgery, Armed Forces Chuncheon Hospital, 57 Banggogae-gil, Chuncheon 24207, Korea Tel: +82-33-243-0130, Fax: +82-33-244-0130 E-mail: greatermd@naver.com

Received 27 December 2019 Revised 13 February 2020 Accepted 14 February 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Congenital, Metatarsal bones, Running, Surgery, Synostosis

References

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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).

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