Background The stress fracture of the fifth metatarsal bone (5MT) frequently occurs in youth soccer players in Japan, and it is very important issue to prevent this fracture. Objective To confirm whether preventive intervention successfully reduced the incidence of 5MT Design Observational cohort study to compare the occurrence of 5MT before (2003-2009) and after (2010-2016) intervention. Setting One football (soccer) club in Japan. Patients (or Participants) One hundred and fifty-nine elite Japanese youth (under 18) football (soccer) players belonged to one football club from 2003 to 2016. The incidence of 5MT were compared before intervention (7 years) and after intervention (7 years). Interventions (or Assessment of Risk Factors) We proposed the prevention strategy on 2010 based on our clinical experiences and past publications regarding with 5MT (https://saita0617.wixsite.com/jones/english-ver ). Main Outcome Measurements Incidence of 5MT. Results The incidence of 5MT before intervention was 11 cases, while it was decreased to 2 cases after intervention. The hazard ratio for the incidence of 5MT was 3.99 (95%CI: 1.06 to 15.05, p=0.04) in the 88 soccer players prior to prevention compared with 71 players post prevention. Conclusions The prevention intervention was effective to reduce the incidence of 5MT in youth Japanese football players.
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