Football Injury News Archive


Will Michael Owen be fit for World Cup?

Saturday 31st December 2005

Newcastle United’s injury nightmare continued with record signing Michael Owen limping out of the Magpies 2-0 defeat to Spurs at White Hart Lane. The initial prognosis is that Owen will be out for four months with a fracture to the fifth Metatarsal.

United manager Graeme Souness described the latest injury set back to afflict his club as, “A disaster for Newcastle United. A disaster for Michael Owen.”

Newcastle United have been reasonably effective with Owen in the team. The England striker has hit seven goals in nine games, transforming the Geordies in the process. Now, the substantial gamble of taking Owen for £16 million from Real Madrid looks to have failed. Without Owen for the rest of the season, Souness and his team will face a tough struggle to stay out of the lower reaches of The Premiership.

Fractures of the Metatarsal bones account for over a third of all foot fractures and were, of course, made famous when England Captain David Beckham suffered a Metatarsal fracture prior to the 2002 World Cup. The shaft of the Fifth Metatarsal on the outer border of the foot is the most commonly injured. Injuries where the fracture is within 1.5cm of the 'tuberosity' (the most prominent part of the Fifth Metatarsal) were first described by Sir Robert Jones, who had injured his own foot in 1896. For this reason these fractures are often called 'Jones fractures'.

Jones fractures are widely believed to begin as 'micro fractures' (where there is an accumulation of microscopic damage to bone cells), which then progress to complete fractures due to repetitive loading during sporting activities. There is often an 'intermediate' stage where the athlete has a 'bone stress reaction' or stress fracture, which is typically accompanied by an aching pain during and following activity.

These fractures are notoriously difficult to treat. There is a high incidence of non-union (where the fracture fragments don't heal) and delayed union (where fracture fragment healing takes much longer than normal). This poor healing is due to a disruption of the blood supply to the Fifth Metatarsal which often corresponds with the fracture site. For this reason surgical fixation is the preferred treatment method of Jones fractures. Surgical fixation involves inserting an intramedullary screw through the middle of the Fifth Metatarsal, followed by a period of restricted weight bearing using a removable plastic cast. The success rate following this surgery is excellent, with a return to sports possible after eight to twelve weeks. However, several complications have recently been reported after use of these techniques. Some studies have described several failures after screw fixation in athletes.

Experts believe that an early return to intense weight bearing activity is believed to be instrumental in delayed union and refracture of the Fifth Metatarsal. For this reason, it is very difficult to define an appropriate time for a safe return to sporting activity. Imaging methods such as CT scans may be helpful when considering a return to activity.

Michael Owen’s injury shouldn’t be a disaster for Sven Goran Eriksson and England fans. Fifth metatarsal fractures are usually fully healed in around four months, meaning the England striker should be available again in plenty of time for the World Cup finals this summer.

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