Proximal metatarsal fractures, often involving the metatarso-cuneiform joint, are occasional components of tarso-metatarsal (Lisfranc) dislocations. Similar fractures of the 4th or 5th metatarsal bases are unusual, as these more mobile rays usually dislocate from the cuboid without fracture.
Injury mechanisms can involve either higher or less significant forces. Deformity may be obvious or subtle.
X-rays in AP, oblique and lateral views should be taken. A CT scan is recommended to confirm or exclude tarso-metatarsal (T-MT) joint involvement.