Childhood metatarsal shaft fractures: treatment outcomes and relative indications for surgical intervention

Journal of Children's Orthopaedics, 05/08/2012

Each metatarsal injury pattern is unique and surgeons should utilize their clinical judgment to determine appropriate treatment; however, there appears to be some relative indications for surgical treatment. Whereas open and articular fractures may be absolute indications for surgery, the relative indications for surgical intervention in metatarsal shaft fractures appear to be adolescent age and multiple fractures. Successful non–surgical management may consist of a short–leg walking cast for a mean of 4 weeks and activity restrictions for an additional month. However, children should be followed to radiographic union, since 15.4 % may have a delayed union and 4.3 % have short–term residual problems related to the injury.

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