title: Treatment dilemma in multiple metatarsal fractures: when to operate?
abstract: Fractures of multiple metatarsals in the pediatric population are uncommon; however, indications for surgical treatment have not been delineated. The aim of this study was to review multiple metatarsal fractures to help refine surgical indications. A total of 98 patients had multiple metatarsal fractures; displacement greater than 10% shaft width (displaced) was encountered in 33 (34.0%) patients. Fifteen patients had displacement of more than 75% shaft width of one metatarsal. Patients older than 14 years of age were more likely to have surgery for their injury (52.6%) than those younger than 14 years of age (3.7%) (P<0.0001). Younger patients and those with less than 75% displacement should be considered for nonoperative care.
  
  
  METHODS
  Level IV.
authors.affiliation: Department of Orthopaedics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Susan T
authors.initials: ST
authors.lastname: Mahan
authors.forename: Anneliese M
authors.initials: AM
authors.lastname: Lierhaus
authors.forename: Samantha A
authors.initials: SA
authors.lastname: Spencer
authors.forename: James R
authors.initials: JR
authors.lastname: Kasser
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D018409:Foot Injuries / Q000601:surgery*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery*; D009985:Orthopedics / Q000379:methods*; D012189:Retrospective Studies