March Fracture (Metatarsal Stress Fractures)

March fractures, ie, metatarsal stress fractures, were first described in 1855, after the foot pain and swelling experienced by Prussian soldiers on long marches. March fractures are metatarsal fractures caused by repetitive stress. Intrinsic patient and extrinsic environmental risk factors contribute to the development of these fractures. A combination of historical features and physical evaluation with imaging can help make the diagnosis. However, prodromal symptoms are common before evidence of a stress fracture is seen on plain radiographs. Radiographs may be negative for 2 to 4 weeks after the onset of symptoms. These stress fractures are typically managed conservatively but can be complicated by nonunion. In such instances, surgical fixation may be indicated.