Condition Articles-First Metatarsal Fractures PDF

First Metatarsal Fractures PDF

Pdf Summary

First metatarsal fractures are important to evaluate because the first ray of the foot has unique anatomical and biomechanical characteristics. The first metatarsal and its associated sesamoids bear approximately one third of the body weight and are important for the stability of the transverse arch. The ligamentous complex of the first metatarsal articulation is different from the other metatarsals, and there is limited motion in this joint. Displaced fractures of the first metatarsal can lead to changes in the biomechanics of the foot and can affect the entire forefoot.<br /><br />Fractures of the first metatarsal can occur due to low energy mechanisms like stress or twisting injuries, or high energy trauma like accidents or motor vehicle accidents. Patients with first metatarsal fractures can present with swelling, pain, and bruising in the foot. It is important to conduct a thorough examination, including inspection, palpation, range of motion, and sensory and vascular exams. Imaging studies like weightbearing radiographs are typically used to evaluate the fracture. MRI or CT scans may be used in certain cases to assess for intra-articular pathology.<br /><br />Treatment for non- or minimally displaced fractures may involve closed treatment with a cast or walking boot for a few weeks. However, if there is displacement, shortening, or angulation of the fracture, surgery may be necessary. Surgical techniques include lag screw placement, plate fixation, or bridge plating fixation. The goal of treatment is to restore the anatomical alignment and length of the first metatarsal.<br /><br />In conclusion, first metatarsal fractures require careful evaluation and treatment due to the important role of the first ray in foot function. Non-displaced fractures can often be treated without surgery, but displaced fractures may require surgical intervention for proper alignment and stability.

Keywords

first metatarsal fractures

foot anatomy

biomechanical characteristics

transverse arch stability

ligamentous complex

biomechanics of the foot

low energy mechanisms

high energy trauma

imaging studies

treatment options