Treatment Protocol for 2nd Metatarsal Fracture

Initial Assessment

Proper radiographic evaluation with three standard views is necessary for accurate diagnosis of a 2nd metatarsal fracture, according to the American Academy of Orthopaedic Surgeons 1
Weight-bearing radiographs provide important information about fracture stability, as recommended by the American College of Radiology 1, 2
Assess for obvious deformity, swelling, bruising, severe pain with movement, or inability to move the foot, as advised by the American Heart Association 3

Regular radiographic assessment to ensure proper healing and alignment is necessary for non-displaced 2nd metatarsal fractures, according to the American Academy of Orthopaedic Surgeons 1

Splinting of the fractured foot is useful to reduce pain, reduce risk for further injury, and facilitate transport to a medical facility, as recommended by the American Heart Association 3

Rigid immobilization is preferred over removable splints for displaced fractures, according to the American Academy of Orthopaedic Surgeons 4
If an open wound is associated with the fracture, cover it with a clean dressing to lower the risk for contamination and infection, as advised by the American Heart Association 3

Progressive weight bearing as tolerated after initial immobilization period is recommended, according to the American College of Sports Medicine 2

If a fractured extremity appears blue, purple, or pale, immediate medical attention is required as this may indicate poor perfusion, as warned by the American Heart Association 3
For patients with diabetes and neuropathy, special attention should be paid to offloading the foot to prevent complications, according to the American Diabetes Association 1
Monitor preadolescent patients for signs of hypothermia if cooling is applied to associated soft tissue injuries, as advised by the American Heart Association 3

Early introduction of physical training and muscle strengthening followed by long-term balance training is recommended after immobilization period, according to the American College of Sports Medicine 1
Avoid prolonged immobilization to prevent stiffness and muscle atrophy, as recommended by the American Academy of Orthopaedic Surgeons 1

Regular radiographic assessment to ensure proper healing and alignment is necessary, according to the American Academy of Orthopaedic Surgeons 1