Which statement is NOT true about Iselin's disease?

Which statement is NOT true about Iselin's disease?

• A. It is a 5th metatarsal apophysitis
• B. Initial treatment is relative rest
• C. Apophyseal fragment runs parallel to the diaphysis
• D. It requires immediate surgical fixation

Answer: (D)

Iselin's disease is a traction apophysitis of the base/tuberosity of the 5th metatarsal in skeletally immature athletes, caused by repetitive pull of the peroneus brevis on the apophysis. This explains why the statements describing it as a 5th metatarsal apophysitis and as an overuse injury with conservative management fit. Initial management focuses on relative rest and activity modification, with immobilization if needed, because the growth plate is still miding and symptoms often resolve with decreased stress and gradual return to activity. The apophyseal fragment running parallel to the diaphysis reflects the direction of traction forces along the metatarsal shaft, so this radiographic/biomechanical detail is consistent with the diagnosis. Immediate surgical fixation is not required in this condition. Surgery is rarely indicated and reserved for uncommon scenarios such as a significantly displaced fragment, nonunion, or failure of conservative treatment.

Iselin's disease is a traction apophysitis of the base/tuberosity of the 5th metatarsal in skeletally immature athletes, caused by repetitive pull of the peroneus brevis on the apophysis. This explains why the statements describing it as a 5th metatarsal apophysitis and as an overuse injury with conservative management fit.

Initial management focuses on relative rest and activity modification, with immobilization if needed, because the growth plate is still miding and symptoms often resolve with decreased stress and gradual return to activity.

The apophyseal fragment running parallel to the diaphysis reflects the direction of traction forces along the metatarsal shaft, so this radiographic/biomechanical detail is consistent with the diagnosis.

Immediate surgical fixation is not required in this condition. Surgery is rarely indicated and reserved for uncommon scenarios such as a significantly displaced fragment, nonunion, or failure of conservative treatment.