Use of minimal internal fixation in an open comminuted second to fifth metatarsal fracture by angle grinder: case report

Abstract

Open comminuted fractures of the metatarsal bones are surgical emergencies that pose a significant challenge for traumatologists. These injuries typically result from high-energy trauma, with common causes including machinery such as lawnmowers, motor saws, and angle grinders. Factors such as the extent of soft tissue damage, neurovascular injury, and fracture stability must be carefully evaluated before surgery. Herein, we present a rare case involving a 37-year-old male who sustained open comminuted fractures of the second to fifth metatarsal bones, along with injuries to the tendons of the long extensors of the toes, the muscle belly of the short extensor, and the dorsal nerves of the foot, following from a trauma with an angle grinder. At the six-month follow-up, the patient reported no complaints and had achieved full weight bearing with the injured foot. In summary, while metatarsal fractures are common in the emergency setting, open fractures of the central and fifth metatarsals are relatively rare. Optimal management requires thorough evaluation and strict adherence to the Gustilo-Anderson protocol, focusing on accurate injury assessment, infection prevention, soft tissue coverage, fracture stabilization, and effective rehabilitation.