Which is a stress fracture of the metatarsal?

• A. March
• B. Jones
• C. Tillaux
• D. Lisfranc

Answer: (A)

A stress fracture of the metatarsal is classically a March fracture, which is a stress fracture of the second metatarsal shaft caused by repetitive marching or running. This pattern fits endurance or military training scenarios where sudden increases in activity load the forefoot repeatedly, leading to microfractures in the metatarsal bone. Clinically, you’d expect forefoot pain and tenderness along the metatarsal shaft that worsens with weight-bearing; early X-rays can be normal, so MRI or bone scan may be needed to confirm. Treatment focuses on rest, protection, and gradual return to activity over several weeks.

The other options describe different injuries: a fracture at the base of the fifth metatarsal from an acute inversion injury (not a typical stress fracture), a distal tibial physeal (growth plate) fracture seen in adolescents, and a ligamentous/arthritic injury of the midfoot (tarsometatarsal joints), respectively.