Table 1.

Reports of Nontraumatic Stress Fractures of the Trapezoid and Second Metacarpal Bones

Study	Age, years/Sex	Time From Onset of Symptoms to Presentation, days	Stress Fracture Location	Type of Sport	Imaging Modalities for Diagnosis	Treatment Type and Duration	Pain Free After Treatment, weeks
Nagumo et al, 2002⁶	21/M	30	Trapezoid	Baseball (batter)	X-ray: normal Bone scintigraphy: increased uptake in trapezoid bone MRI: stress fracture of trapezoid bone with a dorsal bone fragment	Dorsal surgical approach to remove dorsal fragment and refrain from batting (4 wks)	208 (4 yrs)
Heron et al, 2012⁵	22/NA	365-730 (1-2 yrs)	Trapezoid	Shot put	X-ray: normal Bedside ultrasound: normal Bone scintigraphy: increased uptake in trapezoid bone CT: stress fracture of the trapezoid	Thumb spica splint (8 wks)	N/A
Blomquist et al, 2013⁴	21/F	30	Trapezoid	Tennis	X-ray: normal CT: no definite fracture MRI: marrow edema in the trapezoid with a coronally oriented fracture in the midtrapezoid on the sagittal projection	Avoidance of sport activity, PT, splint immobilization (6 wks)	4
Murakami, 1988¹⁶	16/M	7	Base of 2nd metacarpal	Tennis	X-ray: periosteal reaction at ulnar aspect of base of 2nd metacarpal	Avoidance of sport activity (4 wks) + change of grip technique	6
Waninger and Lombardo, 1995¹⁷	14/F	10	Base of 2nd metacarpal	Tennis	X-ray: periosteal reaction at ulnar aspect of base of 2nd metacarpal Bone scintigraphy: positive for stress fracture	Avoidance of sport activity (2 wks) + PT and change to eastern grip technique	6
Bespalchuk et al, 2004¹⁸	15/F	30	Base and shaft of 2nd metacarpal	Tennis	X-ray: periosteal reaction at base and midshaft of 2nd metacarpal CT: cortical thickening at base and shaft of 2nd metacarpal MRI: stress fracture of base and shaft of 2nd metacarpal	Avoidance of sport activity (4 wks) + change to eastern grip technique	12
Muramatsu and Kuriyama, 2005¹⁴	13/F	21	Base of 2nd metacarpal	Soft tennis	Initial x-ray: normal (done elsewhere) X-ray at 3 wks: fracture line and periosteal reaction at base of 2nd metacarpal MRI: stress fracture of base of 2nd metacarpal	Avoidance of sport activity (5 wks) + change to eastern grip technique	12
Fukuda et al, 2008¹⁹	14/F	21	Base of 2nd metacarpal	Badminton	Initial x-ray: normal (done elsewhere) X-ray at 5 wks: periosteal reaction at ulnar aspect of base of 2nd metacarpal	NSAIDs without limiting activity for 5 wks (failed) followed by avoidance of sport activity (3 wks)	5 (after sport restriction)
Balius et al, 2010²⁰	17/F	NA	Shaft of 2nd metacarpal	Tennis (all patients)	X-ray: normal (3 patients) X-ray: periosteal reaction and hairline crack in the cortex (3 patients) Bone scintigraphy: positive (performed in 2 patients with positive x-rays) MRI: increased bone marrow signal intensity (all patients)	PT and avoidance of sport activity (6 to 8 wks) for all patients	6
	17/F		2nd metacarpal				7
	15/F		Shaft of 2nd metacarpal				6
	17/M		2nd, 3rd, and 4th metacarpal				10
	15/F		Shaft of 2nd metacarpal				6
	17/F		2nd metacarpal				6
Rolison and Smoot, 2017²¹	19/M	14	Shaft of 2nd metacarpal	Golf	X-ray: periosteal reaction at ulnar aspect of shaft of 2nd metacarpal MRI: marrow edema in the second metacarpal shaft suggesting stress fracture	Wrist splint, avoidance of sport activity (8 wks) + modified grip technique	16
Duarte et al, 2017¹³	27/M	28	Shaft of 2nd metacarpal	Tennis	X-ray: normal MRI: light bone edema in the 2nd metacarpal shaft with periosteal reaction and 2 lines of hyposignal suggesting stress fracture	Cast immobilization (4 wks) + change of grip	8
Nishikawa et al, 2020²²	13/F	28	Shaft of 2nd metacarpal	Badminton	X-ray: periosteal reaction at ulnar aspect of shaft of 2nd metacarpal (1 patient/tennis player) X-ray: positive for stress reaction (1 patient/location and type of sport NA) X-ray: normal (8 patients) MRI: stress fracture of metacarpal bones (in 8 patients with normal x-rays) MRI: not performed for the 2 patients with abnormal x-rays	All patients treated with avoidance of sports activities + change of grip technique in some patients (advised to change from western to eastern)	4
	14/F	7	Base of 2nd metacarpal	Soft tennis			12
	14/M	21	Base of 2nd metacarpal	Badminton			4
	15/M	28	Base of 2nd metacarpal	Tennis			3
	16/M	14	Shaft of 2nd metacarpal	Tennis			4
	16/F	21	Base of 2nd metacarpal	Tennis			10
	18/F	7	Shaft of 2nd metacarpal	Tennis			4
	18/M	364	Shaft of 2nd metacarpal	Boxing			5
	22/F	7	Shaft of 2nd metacarpal	Tennis			4
	24/M	14	Shaft of 2nd metacarpal	Bowling			4

CT, computed tomography; F, female; M, male; MRI, magnetic resonance imaging; NA, not available; NSAIDs, nonsteroidal anti-inflammatory drugs; PT, physical therapy; x-ray, plain radiograph.