Metatarsal stress fracture treatment Rest from weight-bearing activities as much as possible. Use of a hematoma block or an ulnar nerve block can help reduce the pain during reduction. Symptoms will include pain, swelling, and great difficulty walking. The main goal of treatment is to restore the alignment of all metatarsals, hence maintaining the arches of the forefoot and thereby resulting in the distribution of a normal weight under the head of metatarsals. Second, third and fourth metatarsal bones rarely require surgical intervention, and typically will heal after a period of rest thanks to casting or wearing a special, rigid walking boot . Stress fractures can, however, occur in any of the five metatarsal bones of each foot. Skeleton. Most isolated central (2nd - 4th) metatarsal fractures, as well as non-displaced fractures of the 1st metatarsal, can be treated with a walking boot and progressive weight bearing as tolerated. Treatment depends on the location of the fracture, but most fractures of the fifth metatarsal can be treated conservatively without surgery. @YH8;0012,iHg ]D PMC For example, sometimes a fracture of the first metatarsal bone (behind the big toe) can lead to arthritis. Ligament Reconstructions If they did, contamination with human oral flora is possible, and measures to prevent infection (eg, wound exploration and cleaning, prophylactic antibiotics Antimicrobials Human and other mammal bites (mostly dog and cat bites, but also squirrel, gerbil, rabbit, guinea pig, and monkey bites) are common and occasionally cause significant morbidity and disability read more ) are often required. Walking is our only escape currently and I'm managing 10 mile walks regularly. Walking or running for a long time can result in a stress fracture of the metatarsal. Approximately one-third of metatarsal fractures involve the shaft or distal portion of the metatarsal [ 4 ]. Lateral Ankle Ligament Instability Use for phrases 2012 Nov-Dec;51(6):801-5. doi: 10.1053/j.jfas.2012.06.016. A metatarsal fracture is a break in one of the five long bones which form the middle part of your foot. Chloros GD, Kakos CD, Tastsidis IK, Giannoudis VP, Panteli M, Giannoudis PV. endstream endobj startxref Stress fractures are incomplete breaks in the bone caused by repeated stress rather than a single injury. The foot comprises of many small bones, 5 of which are the long bones known as the metatarsals which are situated beside each other in the mid section of the foot. Treatment of a metatarsal stress fracture The treatment of a metatarsal stress fracture is most often nonoperative. The common presentation involves foot pain and swelling with difficulty in ambulating without support. Toe Joint Fusions The primary aim of the herein study is to present the union time and rate, as well as the functional outcome of the surgically treated isolated lesser metatarsal shaft and neck fractures . 2012 Oct;43(10):1626-32. doi: 10.1016/j.injury.2012.03.010. The metatarsal fracture may result from blunt trauma, possibly sustained in motor vehicle accidents. 28470 - Closed treatment of metatarsal fracture; 28490 - Closed treatment of fracture great toe, phalanx or phalanges; 28510 - Closed treatment of fracture, phalanx or phalanges . Fractures of the metatarsal bones may also . ", "I wanted to write a quick note to say thank you for the surgery last year, it is nearly a year past the operation date. On the day of my operation I had a few fears but they were allayed very quickly. Surgical correction of metatarsal malunion. Tendon Repairs Once this has been done, typical non-operative treatment of immobilization andcrutchesnon-weight bearing, or heel walking is instituted. Deviation of one of these lines suggests a metacarpal fracture. Stress fractures of the metatarsal shaft usually heal well without immobilization, in part because of excellent blood supply. (Left) The four parts of each metatarsal. Surgery is not often required. The trusted provider of medical information since 1899, Pediatric Physeal (Growth Plate) Fractures, Fracture-Dislocation of the Midfoot (Lisfranc Injury), Medically Reviewed Jan 2021 | Modified Sep 2022. official website and that any information you provide is encrypted Relative immobilization in a stiff sole shoe or walker boot for 6-8 weeks is usually adequate. Age. Treatment can include protected weight bearing, immobilization or surgery depending on location of fracture, degree of displacement, and athletic level of patient. There are 5 metatarsals in your foot. Treatment of a metacarpal neck fracture is with a splint (eg, an ulnar gutter splint for fractures of the 4th or 5th metacarpal), usually for at least a few weeks. J Clin Orthop Trauma. Avulsion fractures of the fifth metatarsal bone are treated by open reduction and tension-band wiring or screw fixation if displaced more than 2 mm or with more that 30% of the joint involved. A stiff soled shoe, walking boot, or even a cast may be used. INTRODUCTION Fractures of the proximal fifth metatarsal pose an important diagnostic challenge. All approaches; All preparations; All further reading; Authors of section . Once this has been done, the typical recovery again involves a period of immobilization in a cast,boot, orstiff sole shoesfor 6 or more weeks,allowing for appropriate healing. A common type of break in the part of your fifth metatarsal bone closest to the ankle is called a Jones fracture. A stress fracture can also come from a sudden increase in physical activity or a change in your exercise routine. Displaced fracture may need surgical treatment. Minimally Invasive (Keyhole) Surgery, British Orthopaedics Foot and Ankle Society (BOFAS) Baby Gorilla Talar Neck Plates. hb```"=akaf`f`s|bP(Y =\dpt4tt0tt4ptt hd fg|'C#`dw|sB7YguiF ` .< The fracture was reduced via ORIF with a 6-hole 2.0 Osteomed HPS locking plate. 0 Metatarsal Fracture Non-surgical Treatment. Talar Neck Fracture. Symptoms of a Fifth Metatarsal Fracture. The fracture should then be characterized and treatment initiated. Core tip:Nondisplaced fifth metatarsal fractures can be treated nonoperatively depending on fracture location and patient factors. Patient may suffer with mild to moderate pain for few weeks. The .gov means its official. Physiotherapy is an important treatment for a metatarsal stress fracture. A non-displaced fracture heals in 5 to 6 weeks and functional recovery of the foot near normal takes about 6 to 8 weeks. Treatment. o [ pediatric abdominal pain ] The fracture is a straight line that's angled across the width of your bone. Treatment for a metatarsal fracture can vary and depends on the type, location and severity of your injury. 63 0 obj <>stream American Association of Orthopaedic Surgeons (AAOS) 252 FRACTURE OF FIFTH METATARSAL BONE. As the bone remains aligned after the blow, it is usually easier to treat a non-displaced fracture as compared to a displaced fracture. Mini-Monster Screw System. Epub 2012 Jul 12. Medical Defence Union (MDU), "Many thanks to you and your team for the care and attention given to me before, during and after my recent knee replacement. If the fracture is not displaced or only minimally displaced, it may be treated with rest and immobilization to allow healing. Treatment of Metatarsal Fractures. Isolated metatarsal neck or shaft fractures can be treated with a well-fitted below-the-knee cast or . A prospective randomised comparison of management in a cast versus elasticated support bandage. They cause pain, swelling, tenderness, and sometimes deformity. They typically respond well to cessation of the causative activity. A shaft fracture with acceptable alignment should be treated with heel touchdown weight-bearing. Foot Ankle Int 2004; . Am Fam Physician. He is an expert in sports related injuries of the foot, ankle and knee. Breaks in the metatarsal bones may be either stress or traumatic fractures. A stress fracture, however, may start as a tiny crack in the bone and may not be visible on a first x-ray. The outcome of conservative treatment of fifth metatarsal diaphyseal fractures. You have to wear it until your bone heals completely. An official website of the United States government. Metatarsal fracture refers to the disruption of the physical integrity of any one or multiple of the five metatarsal bones. Polzer H, Polzer S, Mutschler W, Prall WC. sharing sensitive information, make sure youre on a federal If the bone is going to heal in a flexed position, or if allowing it to heal in its present position will cause a permanent lump on the bottom, top, or side of the foot, then manipulating it back into a better position is indicated. Displacement of a first metatarsal fracture usually represents an unstable pattern that requires surgical fixation. Peroneal Tendon Injuries Metatarsal fractures are relatively common injuries of the foot. Forefoot Deformities Metatarsal fractures represent a significant proportion of foot injuries. 1999 May 1;59(9):2516-22. Various patterns of metatarsal injuries exist and the resultant impact on function and quality of life is not. With proximal metatarsal fractures, injury to the proximal ligaments ( Lisfranc injury) should be excluded. Disclaimer, National Library of Medicine It is the most commonly fractured metatarsal bone. Each metatarsal is broken down into segments: the head, neck, shaft, and base. The most common metatarsal stress fracture is a fracture of the neck of the second metatarsal. Technical tip: transverse percutaneous pinning of metatarsal neck fractures. If you experience any pain, however, you should stop your activity and notify your doctor. The Jones Fracture. A fifth metatarsal fracture, or broken 5th metatarsal, requires immediate diagnosis and treatment to avoid long term 5th metatarsal pain, among other potential issues. Clarifying proximal diaphyseal fifth metatarsal fractures. A difference of millimeters in location can lead to a vastly different prognosis and treatment plan; a suboptimal treatment regimen can cause delayed union, reinjury, and chronic disability. Although severely injured metatarsal bones may require surgery, most can heal with rest, ice, compression, and elevation (RICE) or bone stimulation. Oblique fractures occur when your bone is broken at an angle. 2005 Jul;36(7):832-5. If you have fractured several metatarsals at the same time and your foot is deformed or unstable, surgery may be necessary. They occur with a direct injury or a twisting injury to the foot. eCollection 2021 Feb. Yao J, Jin T, Song C, Ju W, Tian Z, Qi B, Wang Y. Staged treatment and internal fixation of floating ankle: A case report and literature review. Metacarpal neck fractures are common. This site needs JavaScript to work properly. 2015 Mar-Apr;54(2):227-9. doi: 10.1053/j.jfas.2014.11.010. This case illustrates the surgical treatment of a second metatarsal shaft fracture that had dorsiflexed and shortened. Achilles Tendon Injuries Metatarsal fractures are among the most common injuries of the foot that may occur due to trauma or repetitive microstress. We help you diagnose your Metatarsal fractures case and provide detailed descriptions of how to manage this and hundreds of other pathologies . Medicine (Baltimore). After six weeks the foot should be X-rayed again to ensure it has healed. The total recovery time before complete unrestricted activities may be resumed is often 6 months or more. hWmS8+,p+=:|0 N$HVyvW:Rh-XDD mDcfH:QD(J$PRWBvhl o [ abdominal pain pediatric ] There are different treatment options for each fifth metatarsal fracture type: In rare instances, it may be necessary to open up the fracture and fix it with screws or a small plate in order to stabilize it in an improved position. Epub 2015 Jan 23. Most metatarsal fractures don't require surgery but you'll need to follow your doctor's treatment plan to ensure you make a full recovery. [Functional outcome of 111 metatarsal fractures following conservative in comparison to operative treatment]. Nondisplaced fractures and fractures of the second to fourth metatarsal with displacement in the horizontal plane can be treated conservatively with protected weight bearing in a cast shoe for 4-6 weeks. Claw Toe / Mallet Toe Correction fractures of the fifth metatarsal located in the junction of the proximal metaphysis and diaphysis. Epidemiology Incidence Arthritis of the Foot & Ankle Nondisplaced or minimally displaced neck fractures; Less than 10 sagittal angulation, 3 - 4 mm displacement in any plane; Immobilization/ Protection . Immobilization and rest You should stay off your. Stress fractures are small cracks in the surface of the bone that may extend and become larger over time. Zone 3 metatarsal neck and shaft fractures: fifth metatarsal neck and shaft fractures are treated the same as central metatarsal fractures. Your specialist will tell you when it is safe to resume activities and return to sports. Since the big toe is used so frequently and bears . Bunionectomy (Bunion Correction) 253 sible to get the amount of weight and the amount of supinationdesired, as at the time the fracture occurs the weight andposition are such that they could be maintained only for oneinstant. Consultant Trauma & Orthopaedic Surgeon with a special interest in the Foot and Ankle. Difficulty walking. The goal of treatment is to achieve a correct reduction of fracture, to avoid prolonged disability and preservation of both soft tissues and bony alignment. Learn more about our robust product offerings for Fracture solutions at Paragon 28. . Diagnosis. Swelling. The site is secure. . Epiphyseal and metaphyseal bone - good to heal with conservative care. FootEducation LLC Certain kinds of fractures of the metatarsal bones present unique challenges. Whether reduction is needed before the splint is applied depends on the fracture. Although not done routinely, you may need your metal plates or screws removed later. Rotational deformity Rotational deformity due to a fracture in the hand may occur. Stress Fractures of the Metatarsals. Injuries to the metatarsal bones are very common and can happen in a number of ways, but most commonly occur when a heavy object falls on them or when they are twisted during a fall. Occasionally the fracture will be markedly displaced and surgery will be required. Most isolated central (2nd - 4th) metatarsal fractures, as well as non-displaced fractures of the 1st metatarsal, can be treated with a walking boot and progressive weight bearing as tolerated. 8600 Rockville Pike [6,7,8,9] The authors report three metatarsal fractures that resulted in non-unions. Great toe fractures are treated with a short leg walking boot or cast with toe plate for two to three weeks, then a rigid-sole shoe for an additional three to four weeks. This area of the bone has low blood flow. Rotational deformity due to a fracture in the hand. The 5th metacarpal is most commonly injured by punching (boxer's fracture). Metatarsal fracture are classified by the following: Open or closed Which digit is involved Location of fracture (base, middle, proximal metatarsal) Displacement and angulation Growth plate involvement (Salter Harris Classification) 3. [1] Clinical Relevant Anatomy The foot consists out of 5 metatarsal bones per foot. The treatment involves conservative management in the form of cast or operative . J Am Podiatr Med Assoc. Fractures can occur in any part of the metatarsal, but most often occur in the neck or shaft of the bone. Toe fractures also occur commonly in children. Mr Pinak Ray is a Trauma and Orthopaedic Surgeon with a special interest in foot and ankle surgery. Most fifth metatarsal fractures can be treated with weight bearing as tolerated, and immobilization in a cast or walking boot. 5th metatarsal fracture The fifth metatarsal bone is the most common metatarsal bone to be fractured in sudden (acute) injury to the foot. It may be broken at various points along its length, depending on the mechanism of injury. Midfoot Joint Fusions Crutches non-weight bearing or heel walking may prevent further displacement. After the splint is removed, patients can gradually begin range-of-motion exercises. An MRI can detect changes in the bone that may indicate a fracture. verify here. An acute injury to the outside part of the front of the foot (base of the little toe) may lead to a 5th metatarsal neck fracture. Most metatarsal fractures can be treated without surgery. Sports Foot & Ankle Injuries Copyright 2022 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. Foot Ankle Int 2005;26:704-707. Reduction is not necessary for dorsal or volar angulation of < 35 for the 4th metacarpal Achilles Tendonitis o [teenager OR adolescent ]. Reduction is not necessary for dorsal or volar angulation of, Fractures of the 2nd and 3rd metacarpals with angulation. A. J Foot Ankle Surg. Jeffrey A. Oster, DPM. doi: 10.1097/MD.0000000000023704. Stress Fractures Metatarsal fractures are relatively common and if malunited, a frequent source of pain and disability. Initial evaluation should focus on identifying any conditions that require emergent referral, such as neurovascular compromise and open fractures. Relative immobilization in astiff sole shoeorwalker bootfor 6-8 weeksis usually adequate. We do not control or have responsibility for the content of any third-party site. Treatment also depends on your: Activity level. Morton's Neuroma Open fractures are serious as once the skin is broken, bacteria can enter the wound and cause infection in the bone. /. Intra-articular Tubercle fracture that extends to intra-articular area May extend to metatarsal-cuboid joint or to the joint with 4th metatarsal. Brought to you by Merck & Co, Inc., Rahway, NJ, USA (known as MSD outside the US and Canada) dedicated to using leading-edge science to save and improve lives around the world. Clipboard, Search History, and several other advanced features are temporarily unavailable. Functional treatment of acute metatarsal fractures. Before , MD, University of California, San Francisco, (See also Overview of Fractures Overview of Fractures A fracture is a break in a bone. 1999 Aug;89(8):398-404. doi: 10.7547/87507315-89-8-398. If the bone is sufficiently out of position, it will need to be manipulated into a better position. Fifth metatarsal fractures: an update on management, complications, and outcomes. It is likely your specialist will request an X-ray, as most fractures are visible on this routine scan. %%EOF This is the complete home treatment guide for . Most metatarsal fractures can be treated non-surgically, with an initial period of elevation and limited weight bearing and following the RICE (Rest, Ice, Compression, Elevate) protocol. Most metatarsal fractures can be treated non-surgically, with an initial period of elevation and limited weight bearing and following the RICE (Rest, Ice, Compression, Elevate) protocol. Luckily, a fifth metatarsal fracture is relatively easy to treat. No operative treatment of fifth . This makes healing difficult. These fractures cause tenderness in the middle of the foot and pain when full weight is put on the foot. . As your broken bone (s) heal over 8-12 weeks, your pain will decrease. Treatments for fifth metatarsal fractures include: Immobilization: If your bones are in place (aligned), your provider may suggest immobilization. You will be immobilized in a plaster cast for 4 weeks and then allowed to bear weight in a boot. Metatarsal fractures are relatively common and if malunited, a frequent source of pain and disability. Distal phalangeal fractures may be complicated by nail bed injuries. Pflger P, Zyskowski M, Vlk C, Kirchhoff C, Biberthaler P, Crnlein M. Unfallchirurg. Please confirm that you are a health care professional. Well find out exactly how to get this bone feeling better! Metatarsal Fracture Clinical Presentation Stress fractures involving the lesser metatarsal bones (typically 2nd or 3rd) will often present with pain and swelling in the midfoot to forefoot. A metatarsal bone fracture is a complete or incomplete break in one of the five metatarsal bones in each foot. If patients have any wounds, particularly linear punctures, near the metacarpophalangeal joint, they should be specifically questioned about whether they punched someone in the mouth. Even with proper healing, your foot may be swollen for several months and it may be hard to find a comfortable shoe. Avulsion and Jones fractures have the . Full recovery of function often takes many months. The area will be painful to touch. Treatment is usually non-operative in a walker boot, with limited mobilization through the heel or non-weight bearing on crutches. General Medical Council (GMC) Nondisplaced or minimally displaced fractures can be treated with a short leg cast or removable boot with minimal weight-bearing over 4 weeks. Fractures of the proximal fifth metatarsal. Epub 2021 May 22. EFORT Open Rev. Several authors have described delayed healing and non-unions of fourth metatarsal fractures and only conservative methods were utilized in each of these cases. Federal government websites often end in .gov or .mil. If there is more than 3-4 mm of displacement or more than 10 degrees of angulation in the sagittal plane surgery is recommended. . Jeff. With an inversion sprain-type injury to the forefoot and ankle, a small piece of bone can be pulled loose. In most cases, a fracture will heal with rest and a change in activities. Stress fractures of the metatarsal bones are increasingly seen in athletes who subject their feet to repetitive, heavy impacts. 2022 Jan 11;7(1):13-25. doi: 10.1530/EOR-21-0025. When these fractures result from punching someone in the mouth, human oral flora may contaminate the wound, sometimes causing infection. Ankle Replacement Treatment of a metacarpal neck fracture is with a splint (eg, an ulnar gutter splint Ulnar gutter splint for fractures of the 4th or 5th metacarpal), usually for at least a few weeks. British Orthopaedic Association (BOA) Avoiding the offending activity, protecting the foot with a boot or protective shoe, and possibly decreasing the patient's weight-bearing status usually helps the fracture to heal without surgery. When the fracture is displaced and surgical treatment is being considered, the pattern of the fracture helps determine the most appropriate fixation. Whether reduction is needed before the splint is applied depends on the fracture. Fifth metatarsal fractures most commonly arise through the base of the bone. Spiral fractures happen when a fracture winds around the . Complete healing of fracture following surgery takes about 5 to 6 weeks. Steinweg MJQ, Prins W, Peters EJ, Zuurmond RG. They usually occur as a result of direct trauma to the forefoot. Stress fractures of the metatarsal can also develop gradually from overuse. European Foot and Ankle Society (EFAS) Treat a metacarpal neck fracture with a splint; if angulation is significant or if rotational deformity is present, reduce the fracture first, usually using closed reduction. The majority of fifth metatarsal fractures are treated without surgery. Injury. They are common in runners and athletes who participate in high-impact sports such as soccer and basketball. Nonoperative treatment of fifth metatarsal fractures in an orthopaedic suburban private multispecialty practice. Nondisplaced fractures and fractures of the second to fourth metatarsal with displacement in the horizontal plane can be treated conservatively with protected weight bearing in a cast shoe for 4-6 weeks. Treatment for a fifth metatarsal fracture depends on whether the broken bones have moved out of place. ", From my first visit, I liked and trusted him. Thank you so much! Orthobiological Joint Injections They're usually caused by landing on your bone at an angle after a fall, or when your bone is hit suddenly from an angle (like in a car accident). The amount of pressure you are able to put on your foot will depend on which bones are broken. It is likely, then, that the relation of the head, tuber-osity and cuboid are . They occur following an acute injury, often from jamming the foot against a solid object. 2022 Apr;125(4):288-294. doi: 10.1007/s00113-021-01006-6. Fractures of the metatarsals are quite common. Companies House Registered Number: OC414512 Registered Company Address: Repton Manor, Repton Avenue, Ashford, Kent, United Kingdom, TN23 3GP, Registered Company Address: Repton Manor, Repton Avenue, Ashford, Kent, United Kingdom, TN23 3GP. Metatarsal Fracture. In this instance, the fracture may be manipulated back into place and stabilized with a wire (pin). If the fracture is not displacedor only minimally displaced, it may be treated with rest and immobilization to allow healing. If patients have wounds near the metacarpophalangeal joint, ask them whether they punched someone in the mouth; if they did, take measures to prevent infection (eg, prophylactic antibiotics). :d,R.|cSll4jx!5(#/$4~E`2ka|}J"22C*f& nF9KdX [D,67X\6[ clnlT,&4bvs]8=19]':^F%*q+mZ6~x9b:U_$aQ6a4aQr}$QVO_yWN@:GTaM0.lpn.0-kxSLR8gq7^ct>wO7{tl!.|J};j^g=Y&1/k,? fs q*9YI1s1]\r'?%\ueUw@)Qb[{q5:.`0w]pN^BEc{)8JP,}E9h\9;xwU,Bv]ty5ipQ9 X He was so caring, kind and respectful - and explained things in details. Most fractures result from a single, significant force applied to normal bone. %PDF-1.6 % Bunions (Hallux Valgus) If the fracture is displaced, the bone (5th Metatarsal head) may be prominent, creating a lump against the skin either on the top, bottom, or outside of the foot. Thank you again. Screw fixation diameter for fifth metatarsal jones fracture: a cadaveric study. The fifth metatarsal is the outer bone that connects to your little toe. In the past, treatment with surgery or non-weight bearing cast would be often employed. This usually occurs from an injury where the foot and ankle are twisted downward and inward. 269 Chestnut St. #271 In these three cases, the first two underwent surgical fixation of the fracture. Epidemiology Incidence frequent injury encountered in primary care setting base of 5th metatarsal fractures account for 25% of all metatarsal fractures 90% are zone 1 fractures Mr Ray provides state-of-the-art medical and surgical services by utilising his expertise in foot and ankle conditions, including arthritis, tendon injuries and deformity corrections. Overall health. Treated with walking cast for 3-6 wks. Ankle Joint Fusion D@-E&6s"NX>n#EFJHhWB+wH4 ": RFRZ:xkvNTNZlTlW+n[jUa^\lgWkD$xqF7_Wy9(;M}:m&m6.O>!1}:32 n(F4J7~/aeLd70N+o#K:.f}DU. Acute fractures to the proximal fifth metatarsal bone: development of classification and treatment recommendations based on the current evidence. Metatarsal neck fractures often affect more than one metatarsal bone and are caused by dropping a weight on the instep, kicking or loading when on tiptoe Causes of Metatarsal Neck Fractures Trauma (generally something heavy landing on the toe or kicking an immovable object) Treatment of Metatarsal Neck Fractures Non-displaced fractures Treatment of 5th metatarsal neck fractures is usually non-operative. Immediate treatment is required to prevent infection. The acute fracture versus the stress fracture. Initial management of non- displaced metatarsal neck fracture will involve immobilisation generally in a CAM walker. CLINICAL ANATOMY It amounts to 5% of all fractures in the upper extremity [1,2,3].The fifth metacarpal neck fracture generally presented palmar angulation owing to the force of the interosseous muscles [].Unsuitable treatments may leave esthetic sequelae and metacarpophalangeal extension deficit. government site. For the purposes of this review, the Jones fracture is referring to as a fracture of the meta- Each metatarsal bone has a base, a shaft, a neck, and a head. Typically, anteroposterior, lateral, and oblique views are diagnostic. Your treating physician will decide this. The fifth metatarsal is the last bone at the outside of the foot, and most breaks of the fifth metatarsal occur at the base. Initial follow-up should occur within one to two weeks, then every two to four weeks for a total healing time of four to . Treatment involves rest and some degree of immobilization for 4 to 8 weeks. Forefoot Neurological Pain Epub 2012 Mar 30. Please enable it to take advantage of the complete set of features! Metatarsal fractures are one of the most common foot injuries encountered in trauma and emergency. Fractures with joint involvement and multiple fragments frequently require open reduction and plate fixation. To minimize and prevent these problems, we describe a simple technique for reduction and fixa-tion of metatarsal fractures by Kirschner wires. Am J Sports Med 2006; 34:476-80. The decision to operate . . 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