Initial Management of Acute Nondisplaced Oblique Fracture of the First Metatarsal Diaphysis

Diagnostic Confirmation

• Obtain standard three-view radiographs of the foot (anteroposterior, lateral, and oblique views) to confirm the diagnosis and assess fracture characteristics, as recommended by the American College of Radiology 1
• If radiographs are equivocal or clinical suspicion remains high despite negative initial films, consider repeat radiographs in 10-14 days or advanced imaging, as suggested by the American College of Radiology 1

Key Clinical Considerations

Common Pitfalls to Avoid

• Ensure adequate immobilization compliance; removable boots allow for non-adherence, which can lead to delayed union or malunion, according to research published in Diabetes/Metabolism Research and Reviews 2
• Monitor for rotational deformity, particularly with oblique fracture patterns, through serial clinical examination and radiographs, as advised by the American Academy of Orthopaedic Surgeons, although the specific guideline is from Praxis Medical Insights, an alternative source is not provided 3