Displaced fractures may be associated with first MTP joint dislocation. Reduction of the articular surface and alignment of the first MTP joint and its associated soft tissues are important in treating this injury.
Look for damage to the plantar plate by assessing sesamoid position on an AP radiograph. Check whether they are spread apart or not. If the volar plate was avulsed, it may interpose itself into the metatarsophalangeal joint and block reduction.