Executive Editor: Joseph Schatzker, Richard Buckley

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

Metatarsals - 1st, head, intraarticular T-type

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Glossary

General considerations

Usually if the first MT head is broken, the foot has sustained significant trauma. Most of these fractures are displaced. But minimally displaced fractures with the hallux in good alignment may be treated nonoperatively.

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.

ORIF or K-wire fixation
Main indication Skill Equipment
Displaced intraarticular fracture Some specialized surgical experience Basic equipment only

Indications

  • Displaced intraarticular fracture (> 2 mm)
  • Multiple intraarticular fractures
  • Dislocations of lesser MTP joints with first metatarsal intraarticular fracture

Contraindications

  • Severely compromised soft tissue or contamination

Advantages

  • Early motion
  • Less pain
  • Anatomic reconstruction of foot anatomy

Disadvantages

  • Occasional painful scarring with ORIF
  • After open fracture increased chance of infection
*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