These injuries include partial and complete articular fractures of the distal metatarsals 1-4.
They are classified as follows:
where 1–4 indicates which metatarsal is injured.
The fractures may also be simple (a) or multifragmentary (b).
The following clinical presentation is typical:
Conventional radiographs of the foot (AP and lateral oblique views) are sufficient for diagnosis and treatment.
CT scans are invaluable for clarification of the fracture pattern and assessing additional fractures of the midfoot.
Fractures may be created with multiple mechanisms:
They may involve either high or low energy mechanisms.
High energy mechanism injuries are often associated with midfoot instability (Lisfranc instability).
Compartment syndrome and Lisfranc injuries should always be suspected.