Post-traumatic synostosis of the metatarsals - a case report

Synostosis refers to the abnormal fusion of bones, which have varying aetiologies as well as sites which are commonly affected. Existing literature mostly describes the condition arising congenitally, and affecting the radio-ulnar joint. A 57-year-old gentleman presented to our department with symptomatic malunion and synostosis of the fourth and fifth metatarsals, two years following non-operative treatment of a closed fifth metatarsal fracture. The patient subsequently underwent surgical excision of the synostosis, but had complications of recurrence at the two-year post-operative date. Repeat surgical excision was performed with eventual good functional outcome and no signs of recurrence. Our paper aims to describe the first known case of post-traumatic synostosis affecting the metatarsals, as well as provide a review of the current literature.