- Fracture of the distal fourth metatarsal
- Plantar plate disruption
- Turf toe
Angulation of the distal fourth metatarsal metaphyseal cortex and hairline lucency consistent with fracture.
Learnings/What to Look for
- Proximal metatarsal fractures are most often caused by crushing or direct blows
- In athletes, an axial load placed on a plantar-flexed foot should raise suspicion of a Lisfranc injury
Pearls for Urgent Care Management and Considerations for Transfer
- Emergent transfer should be considered with associated neurologic deficit, compartment syndrome, open fracture, or vascular compromise
- Referral to an orthopedist is warranted in the case of an intra-articular fracture, or with Lisfranc ligament injury or tenderness over the Lisfranc ligament
Acknowledgment: Images courtesy of Teleradiology Associates.