Intraarticular fracture of the little toe

On the AP view (panel A), two separate fracture lines can be seen (arrows), indicating this is a comminuted fracture (ie, at least three fracture fragments). On the oblique view (panel B), the fracture fragment at the lateral base of the phalanx can be seen to include more than 25 percent of the joint surface, with a small step-off on the joint surface (arrowhead). The presence of a step-off makes this fracture more prone to complications and referral should be considered. Note also the presence of calcified arteries between the first and second metatarsal: the patient is a diabetic with peripheral neuropathy, who did not realize she had broken her toe.