{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T04:32:52Z","timestamp":1762835572857,"version":"build-2065373602"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>In high-energy midfoot fractures with severe soft-tissue damage, immediate osteosynthesis is often challenging owing to the lack of subcutaneous tissue and forefoot swelling. We herein report a case of comminuted first-metatarsal fracture with marked shortening and poor skin condition, managed using a staged approach with external fixation. A 52-year-old man presented with left forefoot pain after a tiller-related mishap. Computed tomography revealed a comminuted first-metatarsal fracture with shortening. Owing to poor condition of the skin, a staged treatment was adopted. In the first stage, an external fixator was applied to correct the metatarsal shortening; in the second stage, a fusion plate was placed between the first metatarsal and medial cuneiform. The external fixator was removed after 4\u00a0weeks. The patient achieved bone union with satisfactory functional outcomes. External fixation allows for delayed definitive fixation until tissue physiology improves, thereby enhancing the stability of internal fixation.<\/jats:p>","DOI":"10.1093\/jscr\/rjaf889","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T04:28:46Z","timestamp":1762835326000},"source":"Crossref","is-referenced-by-count":0,"title":["Staged treatment using external fixation for comminuted fracture of first metatarsal: a case report"],"prefix":"10.1093","volume":"2025","author":[{"given":"Ryogo","family":"Furuhata","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Ashikaga Red Cross Hospital , Ashikaga-shi, Tochigi 326-0843 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Shiba","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Ashikaga Red Cross Hospital , Ashikaga-shi, Tochigi 326-0843 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Tanji","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Ashikaga Red Cross Hospital , Ashikaga-shi, Tochigi 326-0843 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"key":"2025111023284348100_ref1","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1016\/S0891-8422(23)00766-8","article-title":"First metatarsal fractures","volume":"12","author":"Saraiya","year":"1995","journal-title":"Clin Podiatr Med Surg"},{"key":"2025111023284348100_ref2","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1177\/107110070602700303","article-title":"The epidemiology of metatarsal fractures","volume":"27","author":"Petrisor","year":"2006","journal-title":"Foot Ankle Int"},{"key":"2025111023284348100_ref3","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1016\/j.cpm.2010.07.001","article-title":"Metatarsal fractures","volume":"27","author":"Buddecke","year":"2010","journal-title":"Clin Podiatr Med Surg"},{"key":"2025111023284348100_ref4","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1272\/jnms.84.144","article-title":"The Ilizarov mini-external fixator for the treatment of first metatarsal fracture: a case report","volume":"84","author":"Kataoka","year":"2017","journal-title":"J Nippon Med Sch"},{"key":"2025111023284348100_ref5","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1177\/107110070102200506","article-title":"Fractures and fracture dislocations of the midfoot: occurrence, causes and long-term results","volume":"22","author":"Richter","year":"2001","journal-title":"Foot Ankle Int"},{"key":"2025111023284348100_ref6","doi-asserted-by":"publisher","first-page":"514","DOI":"10.2106\/JBJS.E.00228","article-title":"Treatment of primarily ligamentous Lisfranc joint injuries: primary arthrodesis compared with open reduction and internal fixation. A prospective, randomized study","volume":"88","author":"Ly","year":"2006","journal-title":"J Bone Joint Surg Am"},{"key":"2025111023284348100_ref7","doi-asserted-by":"publisher","first-page":"173","DOI":"10.2106\/00004623-198870020-00003","article-title":"Fractures and fracture-dislocations of the tarsometatarsal joint","volume":"70","author":"Arntz","year":"1988","journal-title":"J Bone Joint Surg Am"},{"key":"2025111023284348100_ref8","doi-asserted-by":"publisher","first-page":"1499","DOI":"10.1302\/0301-620X.90B11.20695","article-title":"Primary open reduction and fixation compared with delayed corrective arthrodesis in the treatment of tarsometatarsal (Lisfranc) fracture dislocation","volume":"90","author":"Rammelt","year":"2008","journal-title":"J Bone Joint Surg Br"},{"key":"2025111023284348100_ref9","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1016\/j.fcl.2008.08.002","article-title":"High-energy foot and ankle trauma: principles for formulating an individualized care plan","volume":"13","author":"Tarkin","year":"2008","journal-title":"Foot Ankle Clin"},{"key":"2025111023284348100_ref10","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1177\/107110078100100611","article-title":"Acute management of major trauma involving the foot and ankle with Hoffmann external fixation","volume":"1","author":"Kenzora","year":"1981","journal-title":"Foot Ankle"},{"key":"2025111023284348100_ref11","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/s0891-8422(02)00057-5","article-title":"External fixation in trauma of the foot and ankle","volume":"20","author":"Seibert","year":"2003","journal-title":"Clin Podiatr Med Surg"},{"key":"2025111023284348100_ref12","first-page":"24","article-title":"High-energy midfoot fracture-dislocations: staged treatment with an external fixator","volume":"28","author":"Arvesen","year":"2019","journal-title":"J Surg Orthop Adv"},{"key":"2025111023284348100_ref13","doi-asserted-by":"publisher","first-page":"1287","DOI":"10.1177\/1071100714552077","article-title":"Staged treatment of high energy midfoot fracture dislocations","volume":"35","author":"Kadow","year":"2014","journal-title":"Foot Ankle Int"},{"key":"2025111023284348100_ref14","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1053\/j.jfas.2006.06.002","article-title":"Management of complex open fracture injuries of the midfoot with external fixation","volume":"45","author":"Chandran","year":"2006","journal-title":"J Foot Ankle Surg"},{"key":"2025111023284348100_ref15","doi-asserted-by":"publisher","first-page":"560","DOI":"10.2106\/JBJS.G.00743","article-title":"The safety of forefoot metatarsal pins in external fixation of the lower extremity","volume":"90","author":"Barrett","year":"2008","journal-title":"J Bone Joint Surg Am"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2025\/11\/rjaf889\/65266556\/rjaf889.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2025\/11\/rjaf889\/65266556\/rjaf889.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T04:28:47Z","timestamp":1762835327000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjaf889\/8320161"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,1]]},"references-count":15,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjaf889","relation":{},"ISSN":["2042-8812"],"issn-type":[{"value":"2042-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,11]]},"published":{"date-parts":[[2025,11,1]]},"article-number":"rjaf889"}}