Metatarsal fractures are extremely common injuries accounting for 10% of all fractures seen in our accident and emergency departments (3). The vast majority can be treated conservatively. There is no standardised treatment, but it is commahplace to immobilise the foot and ankle joint in a below-knee back-slab, full cast or functional brace for a period of up to 6 weeks, weight-bearing the patient as pain allows. This practice is time-consuming and expensive, not to mention debilitating, and carries a morbidity risk to the patient.

We describe a simple, effective and cheap treatment method for metatarsal fracture management using the functional forefoot-offloading shoe (FOS). This is clinically proven to offload pressure on the metatarsals and is commonly used in both elective forefoot surgery and in diabetic patients.

Between January and September 2009, we identified 57 patients attending our fracture clinic with new metatarsal fractures. 28 met our inclusion criteria.

All patients reported a significant improvement in their pain

At Injury – mean 8.21 out of 10 (range 4-10)

After FOS fitting - mean 2.92 out of 10 (range 0-6)

The forefoot-offloading shoe is an excellent alternative to plaster casting or functional boot immobilisation, offering high patient satisfaction, an excellent outcome and a considerable cost-saving to the hospital trust.