Metatarsal and toe fractures in children

INTRODUCTION

Most pediatric foot fractures are minor, involve the metatarsal or phalangeal bones, and require a short period of immobilization [1]. Although recovery is usually uneventful, specific metatarsal and toe fractures (eg, Jones fractures, Salter-Harris III or IV fractures of the great toe) require early orthopedic care to avoid significant long-term complications.

The management of metatarsal and toe fractures in children will be reviewed here. Other foot fractures in children and toe fractures in adults are discussed separately. (See "Foot fractures (other than metatarsal or phalangeal) in children" and "Toe fractures in adults".)

EPIDEMIOLOGY

Metatarsal fractures account for the majority of pediatric foot fractures. In children ≤5 years of age, the first metatarsal is most commonly injured [2,3]. In older children, the base of the fifth metatarsal is more frequent [2]. Approximately one-third of metatarsal fractures involve the shaft or distal portion of the metatarsal [1].

Toe fractures also occur commonly in children. The first phalanx (great toe) is most frequently involved. Distal phalangeal fractures may be complicated by nail bed injuries.

RELEVANT ANATOMY

From an anatomic perspective, the foot is divided into three regions (figure 1A-C):

                     

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Literature review current through: Nov 2014. | This topic last updated: Dec 5, 2013.
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References
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