A variant neglected Type IIIA dorsal dislocation of first metatarsophalangeal joint. A case report

Concomitant old complex fracture–dislocation of the first metatarsophalangeal, Lisfranc, and naviculocuneiform joints

Old simultaneous complex fracture–dislocation of the first metatarsophalangeal (MTP), Lisfranc, and naviculocuneiform joints as an overwhelming injury has not been reported in the literature yet. In a 29-year-old man, 6 months following the trauma, the medial column of foot was reconstructed using iliac tricortical bone graft from navicular to the first metatarsal. Arthrodesis of the second and third tarsometatarsal joints and resection arthroplasty of the first MTP joint were done. His clinical and radiographic evaluation after 18 months revealed an acceptable function with returning to pre-injury job but with some limitations in recreational activities.

Level of evidence: level 4

Neglected dorsolateral dislocation of the first metatarsophalangeal joint: A case report

INTRODUCTION

Although the first metatarsophalangeal (MTP) joint is frequently injured, Complete dislocation of the first MTP joint represents a relatively rare traumatic injury.

PRESENTATION OF CASE

A 46-year-old gentleman presented with a traumatic first MTP joint dislocation resulting from an automobile accident. Due to coronavirus outbreak in the hospital at that time, patient was referred to another hospital. Six months later, reduction was achieved surgically and fixation of the MTP with K-wires was done.

DISCUSSION

Only few case reports have described the injury, and the ideal treatment along with the long-term result of the injury has yet to be further studied because reports are rare in this regard.

CONCLUSION

Functional range of motion may result even after 6 months of delayed treatment with ORIF and osteopenia may result.