An unusual case of fracture of the shaft of the lateral four metatarsals with dislocation of the metatarso-phalangeal joint of the big toe following a trivial trauma

Abstract

Metatarsal fractures are about the most common fractures seen in foot injuries. They are however under-reported. The fracture may occur as an isolated injury involving only one metatarsal, concurrently with fractures of additional metatarsals, or as Lisfranc injuries.

These injuries may occur as a result of repetitive stress, low energy trauma, sporting activities or as a result of major trauma as seen in road traffic accidents. The choice of treatment of metatarsal fractures can be either conservative or operative depending on anatomical region involved, patient history and radiological findings. The treatment outcome of these fractures is however not encouraging especially when multiple contiguous sites are involved.

This report looks at a case of fracture of the shaft of the lateral four metatarsals with an associated open dislocation of the first metatarso-phalangeal joint in a diabetic patient following a trivial injury, which was managed by open reduction and k-wire fixation.

Keywords: Foot trauma, Multiple metatarsal fractures, Pathologic fracture, Kirschner wire fixation, Diabetic foot