Annual Report

Executive Editor: Joseph Schatzker, Richard Buckley

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

Metatarsals - 2nd-4th, proximal metaphyseal 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 2nd 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. As well, these fractures may involve the Lisfranc joint and so reduction is important.

ORIF: screw and plate fixation
Main indication Skill Equipment
Displaced intraarticular Lisfranc fractures 2-5, displaced metaphyseal fractures 2-5, displaced first metatarsal fracture with 2-5 metaphyseal fractures Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Indications

  • Intra articular 2 - 5
  • Extra articular 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