Percutaneous Fixation of Metatarsal Fractures

Background: Both children and adults frequently suffer metatarsal bone fractures, which, if untreated, can cause persistent foot pain. Most fractures are treated nonoperatively, but displaced fractures, particularly of the first and fifth metatarsals, require special attention due to their impact on foot function. In cases with significant soft tissue damage or severe misalignment, operative intervention may be necessary. Certain injuries, such as Lisfranc and Jones fractures, remain complex and controversial in their treatment. Aim: was to evaluate and study the functional and radiological short term outcome of percutaneous (k-wire) fixation of metatarsal fractures. Patients and methods: This prospective study reviewed 15 recent cases of closed metatarsal fractures treated at Al-Azhar University Hospitals and Shibin Elkom Teaching Hospital between October 2023 and July 2024. The patients, aged 18 to 55, were assessed using the AO classification and AOFAS score. Radiographs were analyzed for fracture displacement and type, with follow-up evaluations included Results: In this study of 15 patients with closed metatarsal fractures treated with percutaneous pinning, all achieved full radiographic union within 6-9 weeks. AOFAS scores showed significant improvement, with all patients scoring 40 points for pain, 10 points for function, and 15 points for alignment at the end of follow-up. Complications included one case of malunion (6.67%) and two cases of pin tract infection (13.33%). The overall results were excellent for 13 patients and good for 2. Conclusion: Closed reduction and percutaneous pinning for metatarsal fractures resulted in a 90% consolidation rate and return to activity without pain, even without radiographic confirmation. Patients had good range of motion, minimal disability, and no significant radiographic differences between fracture fixation and healing.