Proximal Fifth Metatarsal Fracture Grading Based on XRay

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

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II. Definitions

  1. Torg Classification
    1. Classification of Proximal Fifth Metatarsal Fracture Severity based on XRay findings

III. Indications

  1. Proximal Fifth Metatarsal Fracture AND
  2. Fracture within 1.5 cm of the fifth Metatarsal tuberosity (styloid)

IV. 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

V. 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

VI. Criteria: Torg Type III - Nonunion

  1. Fracture line wide with associated periosteal new bone and radiolucency (bone resorption)
  2. Sclerotic bone obliterates meduallary canal

VII. References

  1. Torg (1984) J Bone Joint Surg Am 66:209-14 [PubMed]

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