Reduction and Fixation of Metatarsal Neck Fracture by Metaizeau's Technique
Phase: NA
Conditions: Displaced Metatarsal Neck Fracture
Sponsor: Sohag University

 
 
 
 
Reduction and Fixation of 
Metatarsal Neck Fracture by 
Metaizeau's Technique 
NCT05640466 
Jul 1st, 2023 

Type of study 
This study was a prospective interventional study. 
Study setting 
The study was conducted at orthopedics department at Sohag General Hospital. 
Study period 
This study was performed in the period between May 2022 and April 2023. 
Patients 
20 patients with displaced metatarsal head fractures were included. 
Criteria of patient selection: 
Inclusion criteria: 
 
Patients with displaced fracture neck metatarsals 2nd, 3rd, and 4th metatarsals. 
Exclusion criteria: 
 
Poly-traumatized patient. 
 
Patient with fracture first and fifth metatarsal bone. 
 
Fracture shaft metatarsal bone. 
 
Open fractures of the foot. 
 
Intraarticular fracture of metatarsals. 
 
Lisfranc fracture. 
 
Segmental fracture of the metatarsal 
Methods: 
All patients were subjected to the followings: 
Metaizeau's technique 
Metaizeau’s technique was applied to reduce the displaced metatarsal head distally from the fracture in 
an easier way and to keep the fracture site closed. 

 
Figure (1): Second, third, and fourth metatarsals displaced head fractures. 
After preparing the metatarsal fracture site for an open reduction. The procedure was performed by the 
senior surgeon who was qualified in the technique. The patients were placed in the supine position on a 
radio-transparent operating table. A Kirschner wire with its distal end is placed showing a small bend 
into the medullar cavity through the lateral margin of the proximal metaphysis of the affected 
metatarsal using a 5mm skin incision at that level. It were able to ease the pin in by drilling a hole on the 
side of the metatarsal bone. The skin incision was made over the interosseus space, to use one incision 
for the two neighboring metatarsal bones. Figure (23) 
 The diameter of the Kirschner wires to be used should be related to the size of the fractured metatarsal 
medullar cavity. It drove the Kirschner wire anterograde, with the help of an X-ray image intensifier. The 
Kirschner wire was driven through the endomedullar cavity from the proximal metaphysis, progressing 
anterogradely towards the displaced distal epiphysis. Once it reached the fracture site, It tried to thread 
the metatarsal head with the bent distal end of the Kirschner wire.  
Subsequently, It rotated the wire 180 to direct its end to the dorsum of the foot so as to provoke a 
translation effect on the metatarsal head in order to obtain the head reduction, and maintained this 
reduction with the Kirschner wire. Open reduction was unnecessary all fractures, leaving the fracture 
site untouched, and preserving the soft tissues, which will collaborate in the healing process of the 
fracture. 

 
Figure (2): Postoperative radiograph showing intramedullary fixation with Metaizeau’s technique 
Postoperative treatment 
Postoperatively, no weight bearing in a splint during the first 2 week was allowed. progressive weight 
bearing cast for the next 2 weeks was permitted after clinical signs consolidation, pain and tenderness 
subsidence, and after 4 weeks we removed the cast and set the patient walking without cast but with 
crutches if needed, and the Kirschner wires were removed 6 weeks following the operation. Figure (3) 
 
Figure (4): Radiographic consolidation of the metatarsal displaced head fractures after 8 weeks, showing 
a correct alignment, no angular deviations, and no shortening of the metatarsal bones.  
Postoperative follow up 

Outpatient follow-up was conducted immediately post-operative until achieving the union. It was done 
4, 8, 24 weeks and 12 months post-operatively. Figure (5) 
Postoperative evaluation 
 
Clinically: neurological and vascular assessment, deformity and stiffness evaluation 
were done. 
 
Radiological: x-ray imaging was performed in the 4th, 8th and 24th postoperative weeks 
to evaluate the alignment and anteroposterior and oblique views of the foot. 
Ethical considerations: 
The study was approved by the Ethics Committee of Faculty of Medicine, Sohag University. There are 
adequate provisions to maintain privacy of participants and confidentiality of the data are as follows: 
 
The patients were given the option of not participating in the study if they did not want 
to. 
 
We put code number to each participate with the name and address kept in a special 
file. 
 
We hide the patients name when we use the research. 
 
We used the results of the study only in a scientific manner and not to use it in any 
other aims. 
Statistical Analysis 
Statistical analysis was done by SPSS v26 (IBM Inc., Chicago, IL, USA). Quantitative parametric 
data were presented as mean and standard deviation (SD). Qualitative variables were presented as 
frequency and percentage (%).