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 at the base of the fifth metatarsal in growing children, caused by repetitive pull from the peroneus brevis tendon on the tuberosity. The typical approach is conservative: relative rest or activity modification, padded or walking boot immobilization if needed, and gradual return to activity as pain and tenderness resolve. Surgery is not the standard treatment and is not performed immediately; it would only be considered if there is significant displacement, nonunion, or failure of conservative management. The apophyseal fragment in this condition generally lies along the shaft of the bone, so the fragment tends to run parallel to the diaphysis, which aligns with how the growth center is oriented and affected by traction.