Surgical Realignment of a Dorsiflexed Metatarsal Fracture

Metatarsal fractures are common injuries that routinely present to outpatient clinics. Whilst usually amenable to conservative care, there is controversy regarding treatment when the fracture results in significant misalignment. In this case report, a 54-year-old female recreational basketball player who sustained a second metatarsal fracture that had healed in a dorsiflexed position in relation to the adjacent metatarsals was referred for a surgical opinion. She had experienced worsening overload pain to her third metatarsophalangeal joint (MTPJ). Open reduction with internal fixation (ORIF) via a 6-hole locking plate was employed to reduce the fracture misalignment and re-establish the metatarsal parabola. She enjoyed an uneventful recovery with a full return to her sporting activities. ORIF with locking plate may be an acceptable technique for reducing displaced metatarsal fractures and re-establishing the metatarsal parabola.