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The Safety of Forefoot Metatarsal Pins in External Fixation of the Lower Extremity
Journal of Bone and Joint Surgery, 03/03/08

Barrett MO et al. - Placement of external fixation pins through the proximal bases of the first and second metatarsals, within 2 cm of the first tarsometatarsal joint, consistently places the deep plantar branch of the dorsalis pedis artery at risk. Given the clinical importance of this artery, transmetatarsal pinning in this fashion is not advised. Other methods of obtaining forefoot or midfoot external fixation are recommended in order to avoid vascular injury.

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