Clinical outcome of screw fixation for stress fractures at the base of the second metatarsal in ballet dancers: A retrospective case series

作者：Matsui T, Sugimoto T, Nagamoto H, Kumai T · 发表于：Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association · 年份：2026 · DOI：10.1016/j.jos.2026.07.003

BACKGROUND: Stress fractures at the base of the second metatarsal are characteristic overuse injuries in ballet dancers, caused by repetitive forefoot loading during pointe work. Conservative treatment may sometimes result in delayed healing or recurrence in a subset of patients. METHODS: We retrospectively reviewed five female ballet dancers with second metatarsal base stress fractures unresponsive to at least 3 months of conservative care, defined as persistent pain with no CT evidence of bone union despite activity restriction and off-loading. All underwent fixation with two Headless Cannulated Screw (HCS) via a dorsal mini-open approach, without immobilization. Outcomes included radiographic union confirmed by CT, time to resumption of pointe work, jumps, and return to preinjury activity level, as well as functional recovery assessed with the JSSF midfoot scale. CT-based union was independently assessed by two observers. RESULTS: All dancers achieved radiographic union within 11 weeks (mean, 7.0 ± 3.4 weeks; median, 6; IQR, 5-10). There was complete agreement between observers (100% agreement; ICC, 1.0 [95% CI, 1.0-1.0]). FWB occurred at a mean of 4.4 ± 3.0 weeks (median, 3; IQR, 3-6). Pointe work resumed at a mean of 7.4 ± 3.2 weeks (median, 6; IQR, 6-8), and jumping at 8.8 ± 3.3 weeks (median, 8; IQR, 7-9). Return to preinjury activity level occurred at a mean of 13.8 ± 5.0 weeks (median, 12; IQR, 10-17). The mean JSSF midfoot score improved from 77.8 ± 5.4 preoperati...