Generally, anatomic reduction and stabilization are essential for achieving a satisfactory outcome. Precise restoration of the congruity and functional relationship involving the respective metatarsals and adjoining lesser tarsus is paramount. Much of the recent literature suggests ORIF as the standard of care. Ensuring anatomic reduction and appropriate postoperative management will optimize clinical outcomes. However, be aware that, in certain cases, posttraumatic squeal may be inevitable even with timely and accurate anatomic reduction. Restoring alignment via an appropriate arthrodesis may be required for cases which are initially neglected, develop significant arthrosis or remain symptomatic in spite of appropriate care.