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ETIOLOGICAL POSSIBILITIES OF MARCH FRACTURES
E. Berkman
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CAMP LEE, VIRGINIA
1943 by The American Orthopaedic Association, Inc.
The Journal of Bone & Joint Surgery.  1943; 25:206-207 
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Abstract

1. The anatomy of the second and third metatarsals should be considered when the etiological factors of march fractures are discussed.

2. Repeated roentgenographic studies are necessary before a true diagnosis is established.

3. The majority of march fractures occur in the second and third metatarsals.

4. Long hikes and stiff army shoes predispose to this particular type of fracture. The long hikes probably cause a severe foot fatigue in new recruits, while the resistant army shoes prevent a proper take-off, and produce excessive stress and strain over the metatarsal heads.

5. Loss of the normal range of motion at the metatarsophalangeal joint, probably due to a tight capsule, predisposes to further loss of proper take-off and a resultant extra load on the metatarsal shafts.

6. The majority of these fractures are easily treated, hospitalization is not long, and the army shoe acts as an ideal splint.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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