Case Presentation: 
Multiple Central Metatarsal Fractures

Tonight we will present an interesting trauma case which has been submitted by Glenn Weinraub, DPM. Dr. Weinraub is an attending at Kaiser Permanente Medical Group, Department of Orthopaedic Surgery, Hayward/Fremont, California.

HPI: 17 yo male presents to ED 4 hr s/p indirect trauma to the left foot while at high school football practice. Initial treatment was posterior splint and RICE. Pt seen in clinic 48 hrs later.

O: L foot with min edema, + ecchymosis, integument intact. + tenderness over the central metatarsals, midshaft. remainder of exam unremarkable.

Xray: displaced midshaft metatarsal fx 3rd and 4th. Greenstick fracture with lateral displacement to the 2nd metatarsal.

A: central metatarsal fx 2,3,4 L foot.

Given this challenging presentation in a young, healthy patient, what is your detailed treatment plan and why? Read next week to see comments from your peers and to see final x-rays…

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John Steinberg, DPM
Editor - PRESENT