Proximal Fifth Metatarsal Fracture Grading Based on XRay


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

  • Definitions
  1. Torg Classification
    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