الفهرس 
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Abstract
Background: Metatarsal fractures represent a common cause of foot pain, accounting for 35% of all foot fractures. Either direct trauma or indirect one can lead to wide range of metatarsal fractures starting from simple isolated fracture up to crushing comminuted injuries. Diagnosis of metatarsal fractures requires the three views radiographs of the foot; anteroposterior, lateral and oblique views. Minimally displaced fractures can be treated conservatively, while fractures which is displaced more than 3 – 4 mm or angulated more than 10 degrees should be reduced and fixed. Percutaneous K-wire fixation is the most popular method of metatarsal fracture fixation. Two techniques can be used for insertion of the wires either retrograde or antegrade one.
Methods: A randomized comparative study between retrograde and antegrade Kwire fixation of metatarsal bone fractures forefoot was done through assessment of forefoot functional outcome after three and six months of fixation by using both using American College of Foot & Ankle Surgeons (ACFAS) & European Foot and Ankle Society (EFAS) scoring scales. Thirty patients participated in our study. Results: In spite of being statistically insignificant, patients who were treated with antegrade fixation showed higher scores of (EFAS) and (ACFAS) at the follow up assessment after three months of their surgeries than the patients treated with the retrograde one, also they started earlier or even immediate painless range of motion at the metatarsophalangeal joints. Moreover, they started early partial and full weight bearing than the patients treated with the retrograde technique. But eventually after six months of the follow up, their (ACFAS) and (EFAS) scores were almost equal. In the other hand the retrograde method is simpler one and requires less intraoperative exposure to radiations.
Conclusion: Patients treated with the antegrade method can return to their daily activities earlier. However, patients treated with the retrograde one exposed to less doses of intraoperative radiations. There is no difference between both methods regarding the time of union or ACFAS and EFAS scoring scales after six months of fixation.