{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:15:12Z","timestamp":1783509312922,"version":"3.55.0"},"reference-count":15,"publisher":"MDPI AG","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>The management of fractures in diabetic patients poses unique challenges, particularly due to complications such as neuropathy, poor bone quality, and impaired healing. This case study explores the nonoperative management of multiple displaced metatarsal fractures in a 61-year-old male with type 2 diabetes and neuropathy. The patient presented with swelling and minimal pain in the right foot without a clear history of acute injury. Despite radiographic evidence of displaced fractures, the patient opted for conservative treatment due to high surgical risks, including comorbidities and concerns about compliance with postoperative care. He was treated with a controlled ankle motion walker and partial weightbearing for 4 months, ultimately achieving healing at all fracture sites except for a malunion in the second metatarsal. Over 28 months, the patient-maintained functionality with diabetic shoes and custom inserts, despite developing a mild metatarsus adductus deformity and evidence of osteoarthritis. This case highlights the potential for conservative treatment of complex metatarsal fractures in diabetic neuropathic patients, emphasizing the importance of individualized management plans and consideration of the patient\u2019s overall health status and preferences. As the prevalence of diabetes rises, this approach could serve as a viable option for similar cases, minimizing the risks associated with surgical intervention.<\/jats:p>","DOI":"10.7547\/23-154","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T10:07:01Z","timestamp":1745575621000},"source":"Crossref","is-referenced-by-count":0,"title":["Nonoperative Management of Multiple Displaced Metatarsal Fractures in a Diabetic Neuropathic Patient"],"prefix":"10.3390","volume":"115","author":[{"given":"Kasra","family":"Behfar","sequence":"first","affiliation":[{"name":"Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA 98108."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Oh","sequence":"additional","affiliation":[{"name":"Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA 98108."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"B1","series-title":"Nutr Metab Cardiovasc Dis","first-page":"1375","article-title":"Bone fragility in patients with diabetes mellitus: a consensus statement from the working group of the Italian Diabetes Society (SID), Italian Society of Endocrinology (SIE), Italian Society of Gerontology and Geriatrics (SIGG), Italian Society of Orthopaedics and Traumatology (SIOT)","volume":"31","author":"Napoli N","year":"2021","unstructured":"Napoli N, Incalzi RA, De Gennaro G, et al: Bone fragility in patients with diabetes mellitus: a consensus statement from the working group of the Italian Diabetes Society (SID), Italian Society of Endocrinology (SIE), Italian Society of Gerontology and Geriatrics (SIGG), Italian Society of Orthopaedics and Traumatology (SIOT). Nutr Metab Cardiovasc Dis 31: 1375, 2021."},{"key":"B2","series-title":"Ther Clin Risk Manag","first-page":"455","article-title":"Fracture risk in patients with type 2 diabetes mellitus and possible risk factors: a systematic review and meta-analysis","volume":"13","author":"Moayeri A","year":"2017","unstructured":"Moayeri A, Mohamadpour M, Mousavi SF, et al: Fracture risk in patients with type 2 diabetes mellitus and possible risk factors: a systematic review and meta-analysis. Ther Clin Risk Manag 13: 455, 2017."},{"key":"B3","series-title":"BMJ Open","first-page":"e024067","article-title":"Diabetes mellitus and the risk of fractures at specific sites: a meta-analysis","volume":"9","author":"Wang H","year":"2019","unstructured":"Wang H, Ba Y, Xing Q, et al: Diabetes mellitus and the risk of fractures at specific sites: a meta-analysis. BMJ Open 9: e024067, 2019."},{"key":"B4","series-title":"J Orthop Trauma","first-page":"e315","article-title":"Rate of and risk factors for intermediate-term reoperation after ankle fracture fixation: a population-based cohort study","volume":"31","author":"Pincus D","year":"2017","unstructured":"Pincus D, Veljkovic A, Zochowski T, et al: Rate of and risk factors for intermediate-term reoperation after ankle fracture fixation: a population-based cohort study. J Orthop Trauma 31: e315, 2017."},{"key":"B5","series-title":"J Am Board Fam Pract","first-page":"179","article-title":"Fracture care by family physicians","volume":"6","author":"Eiff MP","year":"1993","unstructured":"Eiff MP, Saultz JW: Fracture care by family physicians. 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Front Endocrinol (Lausanne) 13: 861878, 2022."},{"key":"B8","series-title":"Pharmaceuticals (Basel)","first-page":"60","article-title":"The treatment of impaired wound healing in diabetes: looking among old drugs","volume":"13","author":"Spampinato SF","year":"2020","unstructured":"Spampinato SF, Caruso GI, De Pasquale R, et al: The treatment of impaired wound healing in diabetes: looking among old drugs. Pharmaceuticals (Basel) 13: 60, 2020."},{"key":"B9","series-title":"JBMR Plus","first-page":"e10243","article-title":"Accelerated cortical osteolysis of metatarsals in Charcot neuroarthropathy: a cross\u2010sectional observational study","volume":"3","author":"Sinacore DR","year":"2019","unstructured":"Sinacore DR, Smith KE, Bohnert KL, et al: Accelerated cortical osteolysis of metatarsals in Charcot neuroarthropathy: a cross\u2010sectional observational study. JBMR Plus 3: e10243, 2019."},{"key":"B10","series-title":"Adv Orthop","first-page":"6236045","article-title":"The effect of vitamin D supplementation for bone healing in fracture patients: a systematic review","volume":"2023","author":"Gatt T","year":"2023","unstructured":"Gatt T, Grech A, Arshad H: The effect of vitamin D supplementation for bone healing in fracture patients: a systematic review. Adv Orthop 2023: 6236045, 2023."},{"key":"B11","series-title":"J Clin Med","first-page":"530","article-title":"Testosterone and bone health in men: a narrative review","volume":"10","author":"Shigehara K","year":"2021","unstructured":"Shigehara K, Izumi K, Kadono Y, et al: Testosterone and bone health in men: a narrative review. J Clin Med 10: 530, 2021."},{"key":"B12","series-title":"Sci Rep","first-page":"31724","article-title":"Efficacy of electrical stimulators for bone healing: a meta-analysis of randomized sham-controlled trials","volume":"6","author":"Aleem IS","year":"2016","unstructured":"Aleem IS, Aleem I, Evaniew N, et al: Efficacy of electrical stimulators for bone healing: a meta-analysis of randomized sham-controlled trials. Sci Rep 6: 31724, 2016."},{"key":"B13","series-title":"Clin Podiatr Med Surg","first-page":"601","article-title":"Metatarsal fractures","volume":"27","author":"Buddecke DE","year":"2010","unstructured":"Buddecke DE, Polk MA, Barp EA: Metatarsal fractures. Clin Podiatr Med Surg 27: 601, 2010."},{"key":"B14","series-title":"Clin Podiatr Med Surg","first-page":"203","article-title":"Primary subtalar joint arthrodesis with internal and external fixation for the repair of a diabetic comminuted calcaneal fracture","volume":"28","author":"Facaros Z","year":"2011","unstructured":"Facaros Z, Ramanujam CL, Zgonis T: Primary subtalar joint arthrodesis with internal and external fixation for the repair of a diabetic comminuted calcaneal fracture. Clin Podiatr Med Surg 28: 203, 2011."},{"key":"B15","series-title":"Foot Ankle Int","first-page":"559","article-title":"The role of internal fixation in the treatment of Jones fractures in diabetics","volume":"17","author":"Yue JJ","year":"1996","unstructured":"Yue JJ, Marcus RE: The role of internal fixation in the treatment of Jones fractures in diabetics. Foot Ankle Int 17: 559, 1996."}],"container-title":["Journal of the American Podiatric Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/japmaonline.org\/view\/journals\/apms\/115\/2\/23-154.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/115\/2\/23-154.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/115\/2\/23-154.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:20:04Z","timestamp":1783506004000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1930-8264\/115\/2\/23154"}},"subtitle":["A Case Study"],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":15,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.7547\/23-154","relation":{},"ISSN":["8750-7315"],"issn-type":[{"value":"8750-7315","type":"print"}],"subject":[],"published":{"date-parts":[[2025,3]]}}}