Distal extraarticular fractures of the 1st to 4th metatarsal

Nondisplaced, acceptable displacement, or compromised soft-tissue envelope

Indications

• Nonambulatory patients
• Medically compromised patients
• Geriatric patients

Metaphyseal fractures of the lesser metatarsals

Further indications

• Multiple metatarsal fractures
• Polytrauma to the foot
• Damage control surgery

Advantages

• Inexpensive

Disadvantages

• Removal of wires in clinic

Length stable metaphyseal fractures

Advantages

• It may be easier to perform than intramedullary wiring

Disadvantages

• More than one K-wire is required
• Possibly more soft-tissue compromise than intramedullary wiring
• Removal of wires in clinic

Simple metaphyseal fractures of the first metatarsal