Annual Report

Executive Editor: Joseph Schatzker, Richard Buckley

Authors: Michael Castro, Richard Buckley, Andrew Sands, Christina Kabbash

Metatarsals - 2nd-4th, subcapital fractures

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Glossary

General considerations

The first metatarsal takes 50% of the body weight with ambulation and so it is most important that anatomic reduction is correct after fractures have occurred. However, the second through 5th metatarsals each take 10-15% of body weight. The careful reconstruction of the 2nd – 5th metatarsals diminishes the chance for late malposition and metatarsalgia. It is common to reduce and fix the first metatarsal and it may properly reposition the 2nd through 5th metatarsals.

ORIF: plate fixation
Main indication Skill Equipment
Displaced subcapital fractures 2-5, displaced first metatarsal fracture with 2-5 subcapital fractures Some specialized surgical experience Simple surgical and imaging resources

Indications

  • Sub capital 2 - 5 
  • With associated first metatarsal displaced fracture

Advantages

  • Proper foot alignment, shape and restoration of articular surfaces
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

v2.0 2017-03-22