First Metatarsal fractures

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First Metatarsal fractures

Result of direct or indirect forces.

Clinical features:
Pain, swelling, ecchymosis, deformity, unable to bear weight, pain on motion, crepitus
X-ray – anterior posterior, lateral and medial obliques.

Fractures of base of metatarsal:
• usually in metaphyseal bone
• most heel in 6 weeks
• Treatment – cast immobilisation

Fracture of shaft of metatarsal:
• if displaced  k-wire fixation
• long term, shortened metatarsal  transfer of weightbearing  symptoms

Fracture of neck of metatarsal:
• isolated undisplaced fracture – only needs symptomatic management with post-op shoe.

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