We reviewed the evolution and final results of 57 patients with central metatarsal fractures treated in Hospital "La Fe" in Valencia between 1982 and 1993. The treatments were nonsurgical in 36 cases and surgical in 21 cases. The most frequent etiologies were traffic accidents, followed by work-related accidents. The fractures were classified according to their anatomic localization and whether they were closed (44 cases) or open (13 cases). Poor functional results manifested by metatarsalgia were present most often when one or two of the following were present: comminution, sagittal plane displacement, open fracture, or severe soft tissue injury. The mean follow-up was 5 years.