Fixation of displaced metatarsal fractures
Reduction and fixation with percutaneous K-wires; rarely screws or miniplates, in selected cases.
Multiple displaced diaphyseal fractures, lesions altering forefoot alignment.
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Surgery · Fractures
Paediatric foot fractures: rare but not to be underestimated
Most paediatric foot fractures are treated without surgery. Those that do require an operation are few — but often go unnoticed for some days: they are worth knowing about.
The core of conservative treatment
What almost never needs surgery
Mildly displaced metatarsal fractures, stress fractures of tibia or metatarsals, some apophysitises mistaken for fractures (e.g. Iselin's disease at the base of the 5th metatarsal).
What deserves extra attention
Lisfranc joint injuries, intra-articular fractures of calcaneus or talus, displaced central metatarsal fractures, fractures associated with high-energy trauma.
Typical surgical procedures
Lisfranc injuries
Reduction and fixation with screws or wires of the tarsometatarsal joint. CT often used to define the extent of the lesion.
Joint diastasis, instability, marked displacement. Lesions that, if missed, leave chronic weight-bearing problems.
More frequent in adolescents, particularly in some sports. Should be suspected when midfoot pain is not explained by a simple sprain.
Intra-articular calcaneus fractures
Rare in children. In selected cases, reduction and fixation with screws or a dedicated plate.
Marked displacement of the posterior facet, high-energy fractures.
Talus fractures
Conservative treatment in most cases. Surgery in displaced talar neck fractures because of avascular necrosis risk.
Significant displacement, neck or intra-articular fractures.
The base of the 5th metatarsal is not always a fracture
In children and adolescents, pain on the outer edge of the foot can be a real fracture, but also a simple apophysitis (Iselin's disease). The X-ray must be read with age in mind: the growth nucleus can look like a fracture line to those unfamiliar with these images.
Questions I receive
Can a child walk on a just-operated foot?
It depends on the fracture and the technique. Some metatarsal fixations allow early partial weight-bearing with a rigid shoe; others require a non-weight-bearing period.
How long before returning to sport?
It varies widely by site and procedure. More than the date, what matters is the clinical picture: absence of pain, motion recovery and regained strength.
A second opinion on a paediatric fracture
Bring the ER report and the X-rays. A focused paediatric orthopaedic visit can clarify indication, timing and alternatives.
Book a visitContent for general informational purposes only. It does not replace a medical evaluation.