Isolated Acute Osteochondral Fracture of the Second Metatarsal Head: An Uncommon Fracture - Case Report and Literature Review

Abstract

Isolated osteochondral fractures of the articular surface of the metatarsal head are rare injuries. To the best of our knowledge, there are less than ten reported cases of an acute isolated osteochondral metatarsal head fracture in the literature and no consensus has been reached regarding the best treatment. Both conservative treatment, through manipulation and close reduction, as well as open reduction and internal fixation were performed with good outcomes. We present a rare case of an isolated slipped-retroverted osteochondral fracture of the second metatarsal head treated by open reduction and internal fixation with a Herbert screw with an excellent outcome. The postoperative period was uneventful, and an excellent outcome was achieved. This case highlights the importance of a careful clinical and radiological evaluation for these rare lesions in order to avoid the undesirable sequelae of a missing diagnosis.

Acute Osteochondral Fracture of the Metatarsal Head: A Report of Two Cases and Review Of Literature

“…Management of osteochondral fracture of the metatarsal head is still unclear due to the small number of reported cases in the literature [10]. The goal of treatment is to restore the congruity of the articular surface.…”

“…The two-Kwire technique described by Atik et al for metatarsophalangeal distraction to allow enough articular space for reduction can be helpful to avoid articular surface damage [7]. Internal fixation can be achieved using Kwires, screws, or bioabsorbable pins [1,2,6,7,9,10,12]. Table 3 represents all cases of traumatic MHOCF reported in the literature in addition to the treatment strategy adopted by each author and their respective outcomes [1,2,[5][6][7][8][9][10]12,13].…”

“…Internal fixation can be achieved using Kwires, screws, or bioabsorbable pins [1,2,6,7,9,10,12]. Table 3 represents all cases of traumatic MHOCF reported in the literature in addition to the treatment strategy adopted by each author and their respective outcomes [1,2,[5][6][7][8][9][10]12,13].…”