Magazine article The New Yorker

THE VINEYARD FRACTURE; EPIDEMIOLOGY DEPT. Series: 3/5

Magazine article The New Yorker

THE VINEYARD FRACTURE; EPIDEMIOLOGY DEPT. Series: 3/5

Article excerpt

Even the leisure class has its occupational hazards: tennis elbow, hangovers, red tide, gout. The Palm Beach diarrhea outbreak of 1996 was the result of a bad crop of raspberries; a few weeks ago, off the coast of Bermuda, a sportfisherman was impaled by a blue marlin as it vaulted across the stern of his boat. Now, from Martha's Vineyard, comes word of a new resort-town scourge. Dr. Rocco Monto, the island's only orthopedist, says that, over the past six years, more than six hundred people in the area have fractured their fifth metatarsals. (The fifth metatarsal is the bone that parallels the outer edge of the foot.) As Monto told Ian Fein, of the Vineyard Gazette, "We have the world's largest collection of these fractures, by an extraordinary amount." Fein had recently fractured his fifth metatarsal, coming down from a rebound in a game of hoops.

The metatarsal fracture was first diagnosed in 1902, by the surgeon Sir Robert Jones, who had hurt his foot at a garden party while skipping around a Maypole. The Jones fracture, as it came to be called, occurs near the ankle end of the bone, and befalls dancers and soccer players (the metatarsal is known in England as "the Beckham bone"); the Vineyard fracture, meanwhile, is an avulsion fracture--the ankle twists, jerking the connecting tendon and a piece of bone away from the foot--and afflicts an athlete of a different sort. "Many of them are people who are getting off their decks, usually after dinner, usually after a couple of glasses of wine, and the steps are not quite so easy to negotiate," Monto said the other day, from his office in West Tisbury.

Still, it's tough to chalk up those figures to sauvignon blanc alone. Two summers ago, Monto presented his data to the American Orthopaedic Foot and Ankle Society. (Monto, who was trained at N.Y.U. and Duke, prefers to set the foot in a short, removable walking boot instead of the traditional cast. He has submitted his research for publication in the Journal of Foot and Ankle Surgery.) "The professor who reviewed the paper--I guess he thought I was making the data up--sat up on the podium," Monto said, "and asked, 'What's going on? Are they just klutzes over there? …

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