From the Research
For a chip fracture of the 1st Metatarsophalangeal (MTP) joint of the left foot, a rigid or semi-rigid orthopedic splint, specifically a walking boot or a post-operative shoe with a rigid sole, is recommended. This type of splint provides adequate immobilization while allowing for some weight-bearing, which is crucial for the healing process. The splint should extend from the mid-foot to beyond the toe to properly immobilize the MTP joint and prevent movement that could displace the fracture fragment.
According to the most recent and highest quality study available, 1, the use of a controlled ankle motion (CAM)-walker boot can lead to earlier signs of complete healing compared to a hard-soled shoe. However, the study focused on zone 1 fractures of the proximal fifth metatarsal, which may not directly apply to chip fractures of the 1st MTP joint. Nevertheless, the principle of immobilization and controlled weight-bearing remains relevant.
Treatment usually requires wearing the splint for 3-6 weeks, depending on the severity of the fracture and healing progress. During this time, partial weight-bearing with crutches may be necessary initially, progressing to full weight-bearing as pain allows. Elevation of the foot when sitting or lying down, application of ice for 15-20 minutes several times daily for the first 48-72 hours, and appropriate pain management with acetaminophen or NSAIDs (if not contraindicated) are important adjunctive measures.
It's worth noting that other studies, such as 2 and 3, provide general guidance on the treatment of foot fractures and the importance of proper immobilization and weight-bearing. However, the specific recommendation for a chip fracture of the 1st MTP joint is based on the principles of fracture management and the need for immobilization and controlled weight-bearing.
In terms of specific splint options, a walking boot or a post-operative shoe with a rigid sole is often the most appropriate choice, as it provides the necessary immobilization and support for the MTP joint. The choice of splint may vary depending on the individual patient's needs and the severity of the fracture, but the overall goal of treatment remains the same: to stabilize the fractured bone fragments, prevent further displacement, and allow the body's natural healing processes to repair the fracture while maintaining proper alignment of the joint.