Another Classification of First Metatarsophalangeal Joint Dislocation-Type 3: Review and Case Description of the Plantar Dislocation

First Metatarsal Headphones-Like Lesion: A Case of Unreducible Sesamoid Complex Dislocation

CASE

A 34-year-old woman sustained a direct trauma to the left hallux during a fall. Radiographs showed a dorsal dislocation of the first metatarsophalangeal joint and a wide separation of sesamoid complex. Closed reduction was tried: postreduction radiographs displayed reduction of first metatarsophalangeal joint and a complete sesamoid complex dislocation. The patient was scheduled for surgery. Through a medial approach, open reduction together with plantar structures release and repair were performed. Functional and radiographic outcomes were satisfactory at the last follow-up.

CONCLUSION

In case of a "headphones-like lesion" surgery is required, together with plantar structures repair.

Paediatric sand toe: radiographic, ultrasound and MRI findings of dorsomedial capsular injury

Hyperflexion injury to the metatarsophalangeal joint of the great toe, referred to as sand toe, can cause significant functional impairment. To our knowledge, there have been no radiological descriptions of this injury in the paediatric age group. Here, we report radiographic, sonographic and MRI findings in a male paediatric patient who sustained a sand toe injury, highlighting structural damage to the dorsomedial capsule and medial sagittal band, and discuss sand toe's favourable prognosis with conservative management.

Lateral Collateral Ligament Reconstruction Using Suture-tape for Chronic Varus Metatarsophalangeal Instability of The Hallux

Chronic varus instability or recurrent subluxation following isolated metatarsophalangeal dislocation of the hallux is a rare injury. A young Judo athlete with a history of repetitive sport injuries complained of recurrent medial dislocation of the hallux for 3 years. For prior injuries, he underwent manual reduction under local anesthesia and recovered with splint immobilization. Physical examination and fluoroscopic radiograph demonstrated the reducible but unstable first metatarsophalangeal joint to slight varus stress, and magnetic resonance imaging revealed an insufficient remnant of the lateral collateral ligament. For patients with the failed conservative treatment, no consensus has been reached regarding the best joint-salvage procedure to achieve a restoration of metatarsophalangeal stability and a fast return to sport activity. We report a case who achieved satisfactory clinical outcome through the collateral ligament reconstruction using a suture-tape.