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Proximal Fifth Metatarsal Fracture Grading Based on XRayAka: Torg's Classification System for Proximal Fifth Metatarsal Fractures, Torg Classification

Definition
1. Classification of Proximal Fifth Metatarsal Fracture Severity based on XRay findings
Indications
1. Proximal Fifth Metatarsal Fracture and
2. Fracture within 1.5 cm of the fifth metatarsal tuberosity (styloid)
Criteria: Torg Type I - Early
1. Sharp margins and no widening of Fracture line on plain film XRay
2. No periosteal reaction or intramedullary sclerosis, and minimal cortical hypertrophy
Criteria: Torg Type II - Delayed
1. Fracture line with cortical involvement above and below as well as periosteal bone union
2. Wide Fracture line with contiguous radiolucency suggesting bone resorption
3. Intramedullary sclerosis
Criteria: Torg Type III - Nonunion
1. Fracture line wide with associated periosteal new bone and radiolucency (bone resorption)
2. Sclerotic bone obliterates meduallary canal
References
1. Torg (1984) J Bone Joint Surg Am 66:209

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This page was written by Scott Moses, MD. This page was last revised on 11/11/2007 2:17:00 PM. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.