Médecine et chirurgie du pied


Anterograde Intramedullary Pinning in Middle Metatarsal Fractures Volume 30, issue 2, Juin 2014



Despite being common, there are very few articles about metatarsal fractures either concerning surgical techniques or clinical results. This type of fracture may need surgical correction when displaced, especially at an angle. The authors are reporting on the surgical technique and the clinical results of closed anterograde intramedullary pinning of fractures of the neck, diaphysis and the head of the metatarsals.

Equipment and methods

Thirty-one patients with a metatarsal fracture from January 2009 to June 2012 were reviewed retrospectively by the authors. The study included 24 males and 7 females and comprised of 41 fractures of either the diaphysis, the neck or the head of the metatarsal. The technique is described, whereby the pin was introduced from front to back via a small dorsal incision at the base of the metatarsals. The consolidation, the range of movement of the metatarsal phalangeal joint and residual pain were assessed at 6 weeks post surgery and at the final follow-up appointment. The American Orthopaedic Foot and Ankle Society (AOFAS) score was assessed at the last follow-up consultation.


Consolidation was achieved on average after 7.3 weeks (ranging from 6 to 10 weeks). Two patients presented with a moderate limitation to the metatarsal phalangeal joint at 6 weeks, however they had recovered full mobility at the last follow-up appointment. The AOFAS score was 94.7 points (range: 81 to 99).


Due to this simple, reliable and minimally invasive technique, all patients were immediately able to start moving their joint, with partial weight bearing with the help of a rigid boot cast. The overall result is satisfactory and there are very few complications.