Chip fractures of the first metatarsal head. Primary fragment excision versus immobilization: a report of four cases.

Four cases of a distal lateral impaction fracture of the first metatarsal are presented. Two treatment schemes were implemented. In two of the patients the fracture fragment was removed early. The other two patients had either percutaneous pinning or a weightbearing cast Each case discusses the rationale for the selected treatment as well as the clinical outcome. All four patients ultimately had successful retums to full activity with a more immediate return to exercise for the two patients with excised fracture fragments (6-week difference).