Isolated floating first metatarsal: report of an unusual injury.

The floating metatarsal is an extremely rare type of injury in which the first metatarsal is dislocated both proximally and distally. Associated injuries and especially metatarsal fracture appear to be rules rather than exceptions. An unreported type of foot injury consisting of isolated floating first metatarsal is described. The absence of any metatarsal fracture makes it exceptional. The importance of following an order of reduction of the joints to relieve tension on the plantar fascia has been highlighted. When examining a patient with metatarsophalangeal joint injury, one should always look for injury at the tarsometatarsal joint and vice versa, because various concomitant injuries are possible and misdiagnose can cause long-term secondary disability.