{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:52:00Z","timestamp":1791582720821,"version":"4.3.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T00:00:00Z","timestamp":1698710400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To compare the clinical, radiologic, and functional outcomes between shockwave and operative treatments for proximal fifth metatarsal stress fractures in soccer players in a pilot study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Between 2017 and 2019, 18 soccer players with fifth metatarsal stress fractures attended at Mutualidad de Futbolistas Espa\u00f1oles\u2013Delegaci\u00f3n Catalana were included. Patients were randomly assigned into 2 groups receiving either surgery with an intramedullary screw (group 1) or high-energy focused extracorporeal shockwave treatment (group 2 performed once a week for 3 weeks using 2000 impulses at an energy flux density of 0.21\u2009mJ\/mm\n                      <jats:sup>2<\/jats:sup>\n                      and 4\u2009Hz frequency). Clinical (pain), radiologic (bone healing), and functional (Tegner Activity Scale and American Orthopaedic Foot &amp; Ankle Society [AOFAS] ankle-hindfoot scales) outcomes before and after receiving the treatment were compared between both groups. In addition, ability and time to return to play was also compared between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>No patients were lost to follow-up. There were no statistically significant differences at last follow-up between surgery and extracorporeal shockwave treatment for bone healing, pain relief, AOFAS ankle-hindfoot score, Tegner score, and time return to play. No complications were reported in either of the 2 groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In this pilot study, extracorporeal shockwave treatment and operative treatment were found to be equally effective at reducing pain, achieving bone healing, and allowing the soccer players to return to play after proximal fifth metatarsal stress fractures. This study suggests that ESWT may be a good option for the management of proximal fifth metatarsal stress fractures in soccer players. If this approach proves successful in larger trials, the shockwave approach might help avoid known complications of the surgical treatment like wound problems, nerve injury, and hardware intolerance. Further investigations with larger sample size should be conducted in order to confirm the present conclusions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level II, therapeutic, pilot randomized controlled trial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10711007231199094","type":"journal-article","created":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T08:21:34Z","timestamp":1698740494000},"page":"1256-1265","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Shockwave Treatment vs Surgery for Proximal Fifth Metatarsal Stress Fractures in Soccer Players: A Pilot Study"],"prefix":"10.1177","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9696-065X","authenticated-orcid":false,"given":"Silvia","family":"Ramon","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Hospital Quir\u00f3nsalud Barcelona, Spain"},{"name":"Fundaci\u00f3n Garc\u00eda-Cugat, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6070-2133","authenticated-orcid":false,"given":"Giacomo","family":"Lucenteforte","sequence":"additional","affiliation":[{"name":"Policlinico Vittorio Emanuele, Universit\u00e0 degli Studi di Catania, Catania, Italy"},{"name":"Isokinetic Medical Group, FIFA Medical Centre of Excellence, Education & Research Department, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8979-8404","authenticated-orcid":false,"given":"Eduard","family":"Alentorn-Geli","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Garc\u00eda-Cugat, Barcelona, Spain"},{"name":"Mutualidad de Futbolistas Espa\u00f1oles\u2013Delegaci\u00f3n Catalana, Federaci\u00f3n Espa\u00f1ola de F\u00fatbol, Barcelona, Spain"},{"name":"Instituto Cugat, Hospital Quir\u00f3nsalud Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilbert","family":"Steinbacher","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Garc\u00eda-Cugat, Barcelona, Spain"},{"name":"Mutualidad de Futbolistas Espa\u00f1oles\u2013Delegaci\u00f3n Catalana, Federaci\u00f3n Espa\u00f1ola de F\u00fatbol, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roc\u00edo","family":"Unzurrunzaga","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Hospital Quir\u00f3nsalud Barcelona, Spain"},{"name":"Fundaci\u00f3n Garc\u00eda-Cugat, Barcelona, Spain"},{"name":"Department of Physical Medicine and Rehabilitation, MC Mutual, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"\u00c1lvarez-D\u00edaz","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Garc\u00eda-Cugat, Barcelona, Spain"},{"name":"Mutualidad de Futbolistas Espa\u00f1oles\u2013Delegaci\u00f3n Catalana, Federaci\u00f3n Espa\u00f1ola de F\u00fatbol, Barcelona, Spain"},{"name":"Instituto Cugat, Hospital Quir\u00f3nsalud Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Barastegui","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Garc\u00eda-Cugat, Barcelona, Spain"},{"name":"Mutualidad de Futbolistas Espa\u00f1oles\u2013Delegaci\u00f3n Catalana, Federaci\u00f3n Espa\u00f1ola de F\u00fatbol, Barcelona, Spain"},{"name":"Instituto Cugat, Hospital Quir\u00f3nsalud Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebasti\u00e1n","family":"Grossi","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Garc\u00eda-Cugat, Barcelona, Spain"},{"name":"Mutualidad de Futbolistas Espa\u00f1oles\u2013Delegaci\u00f3n Catalana, Federaci\u00f3n Espa\u00f1ola de F\u00fatbol, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Sala","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Garc\u00eda-Cugat, Barcelona, Spain"},{"name":"Mutualidad de Futbolistas Espa\u00f1oles\u2013Delegaci\u00f3n Catalana, Federaci\u00f3n Espa\u00f1ola de F\u00fatbol, Barcelona, Spain"},{"name":"Escola Universit\u00e0ria Gimbernat, Universitat Aut\u00f2noma de Barcelona, Sant Cugat del Vall\u00e8s, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3155-7421","authenticated-orcid":false,"given":"Adri\u00e1n","family":"Martinez-De la Torre","sequence":"additional","affiliation":[{"name":"Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6019-4167","authenticated-orcid":false,"given":"Giulia Rita Agata","family":"Mangano","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Cusc\u00f3","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Garc\u00eda-Cugat, Barcelona, Spain"},{"name":"Instituto Cugat, Hospital Quir\u00f3nsalud Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Rius","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Garc\u00eda-Cugat, Barcelona, Spain"},{"name":"Mutualidad de Futbolistas Espa\u00f1oles\u2013Delegaci\u00f3n Catalana, Federaci\u00f3n Espa\u00f1ola de F\u00fatbol, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0940-4557","authenticated-orcid":false,"given":"Alfred","family":"Ferr\u00e9-Aniorte","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Garc\u00eda-Cugat, Barcelona, Spain"},{"name":"Instituto Cugat, Hospital Quir\u00f3nsalud Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram\u00f3n","family":"Cugat","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Garc\u00eda-Cugat, Barcelona, Spain"},{"name":"Mutualidad de Futbolistas Espa\u00f1oles\u2013Delegaci\u00f3n Catalana, Federaci\u00f3n Espa\u00f1ola de F\u00fatbol, Barcelona, Spain"},{"name":"Instituto Cugat, Hospital Quir\u00f3nsalud Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,10,31]]},"reference":[{"key":"bibr1-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-009-0784-3"},{"key":"bibr2-10711007231199094","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2011.0746"},{"key":"bibr3-10711007231199094","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200011000-00002"},{"key":"bibr4-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1177\/03635465010290010201"},{"key":"bibr5-10711007231199094","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2018.7884"},{"key":"bibr6-10711007231199094","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v7.i12.793"},{"key":"bibr7-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1177\/0363546508330143"},{"key":"bibr8-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1016\/j.orthres.2003.10.005"},{"key":"bibr9-10711007231199094","doi-asserted-by":"publisher","DOI":"10.5812\/atr.33298"},{"key":"bibr10-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2009.09.008"},{"key":"bibr11-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1177\/036354658301100513"},{"key":"bibr12-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2005.08.012"},{"key":"bibr13-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517753376"},{"key":"bibr14-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0838.2010.01171.x"},{"issue":"4","key":"bibr15-10711007231199094","first-page":"138","volume":"1","author":"Frairia R","year":"2012","journal-title":"Muscles Ligaments Tendons J"},{"key":"bibr16-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1177\/2325967115603654"},{"key":"bibr17-10711007231199094","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.I.00653"},{"key":"bibr18-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1016\/j.sjpain.2016.06.012"},{"key":"bibr19-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1097\/01.jsm.0000188207.62608.35"},{"key":"bibr20-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-475X.2009.00504.x"},{"key":"bibr21-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2015.07.723"},{"key":"bibr22-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1177\/1941738117747868"},{"key":"bibr23-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2008.12.002"},{"key":"bibr24-10711007231199094","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.17.00661"},{"key":"bibr25-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/1397252"},{"key":"bibr26-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2005.08.010"},{"key":"bibr27-10711007231199094","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-52.8.01"},{"key":"bibr28-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506297540"},{"key":"bibr29-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2013.02.005"},{"key":"bibr30-10711007231199094","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198466020-00007"},{"key":"bibr31-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1016\/j.recot.2011.07.006"},{"key":"bibr32-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-008-0663-1"},{"key":"bibr33-10711007231199094","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200605000-00036"},{"key":"bibr34-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1177\/03635465000280051901"},{"key":"bibr35-10711007231199094","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2009.05.035"}],"container-title":["Foot &amp; Ankle International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10711007231199094","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10711007231199094","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10711007231199094","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T21:22:01Z","timestamp":1777411321000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10711007231199094"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,31]]},"references-count":35,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1177\/10711007231199094"],"URL":"https:\/\/doi.org\/10.1177\/10711007231199094","relation":{},"ISSN":["1071-1007","1944-7876"],"issn-type":[{"value":"1071-1007","type":"print"},{"value":"1944-7876","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,31]]}}}