Annual Report

Executive Editor: Joseph Schatzker, Richard Buckley

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

Metatarsals - Crush injuries

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Glossary

General considerations

Temporary percutaneous pinning of the foot will increase stability, maintain alignment and hasten resolution of swelling.

When soft tissue swelling is sufficiently resolved, open reduction with bridge plating of these fractures may be performed to reconstruct the anatomy of the foot.

ORIF or K-wire fixation
Main indication Skill Equipment
Displaced first metatarsal shaft or multiply displaced metatarsal shafts Highly experienced and skilled surgeon Simple surgical and imaging resources

Indications

  • Displaced intraarticular fracture (> 2 mm)
  • Multiple intraarticular fractures
  • Dislocations of lesser MTP joints with first metatarsal intraarticular fracture
  • Combination Lisfranc and metatarsal fractures that are displaced
  • Open fractures

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