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Diagnosis
Fractures of 1st toe proximal phalanx and heads of the third and fourth metatarsals.
Teaching
Points
The fracture in the 1st toe proximal phalanx is relatively easy to spot. Did you give up when you saw this? The fractures of the metatarsal heads are more difficult to see but are more obvious when you compare with the other side. The key message here is don't be guilty of satsfaction of search. Approximately 15% of fractures are multiple. When you find one abnormality keep looking until you are completely satisfied the rest of the film is normal.
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