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Little information exists regarding open fractures of the foot and no studies have reported open metatarsal fractures. Limited local soft tissue coverage makes this a distinct type of injury. Ten patients with open metatarsal fractures were treated. Six sustained Gustilo Grade I or II injuries; all healed without the need for additional soft tissue coverage. Four patients with Gustilo IIIB developed complications and all went on to eventually require amputation. This data indicates less severe open metatarsal fractures heal without complications, but more severe injuries require amputation.