Dislocation of the first metatarsophalangeal joint with fracture of fibular sesamoid. A case report

Dorsal Dislocation of the First and Second Metatarsophalangeal Joint: A Case Report and Literature Review

Dorsal dislocation of the toes is an infrequent injury that can result in severe pain and deformity. Timely diagnosis and appropriate management are paramount for optimizing patient outcomes. This case report illustrates a 53-year-old male patient who suffered dorsal dislocation of the first and second metatarsophalangeal (MTP) joints due to a crush injury. We present the clinical manifestation, radiographic findings, and management approach for this unique isolated first and second ray MTP joint dorsal dislocation, without any associated fractures. This case report underscores several critical observations: firstly, hallux dorsal dislocation can potentially coincide with other injuries; secondly, it can stem from crushing trauma to the big toe; and thirdly, successful closed reduction, when followed by effective immobilization and early rehabilitation, can yield outstanding outcomes. Additionally, the report emphasizes the importance of pursuing another closed reduction attempt under general anesthesia, if the initial attempt in the emergency room proves unsuccessful, before contemplating open reduction.

Incarcerated Plantar Dislocation of the First Metatarsophalangeal Joint: Reduction Using Intra-articular Saline Injection

Plantar dislocation of the first metatarsophalangeal (MTP) joint is exceedingly rare, and in prior reported cases, simple closed manipulation easily enabled reduction. We present here the first reported plantar dislocation that failed closed manipulation. We also report a technique involving injection of saline into the joint to facilitate reduction. The saline insufflation likely relieves buttonholing of the metatarsal head through the dorsal joint capsule. For first MTP joint plantar dislocations that fail reduction with manipulation, we recommend attempting injection of the joint with saline prior to subjecting the patient to open reduction.

LEVELS OF EVIDENCE

Therapeutic, Level IV: Case report.

Dislocation of the First Metatarsophalangeal Joint: A Case Report and Suggested Classification System

Dislocation of the first metatarsophalangeal joint is a relatively rare and still poorly known injury. The current classification includes only the dorsal variety of this lesion; thus, as further cases of other varieties are reported, a larger understanding of this entity is required. We report the case of a young male with dorsal dislocation of the first metatarsophalangeal joint treated by closed reduction. The clinical outcome at the 2-year follow-up point is reported. A review of the published data of the variations of this injury reported to date is included, and a new summarizing classification is suggested.

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.

Dorsal dislocation of the great toe in a professional football player: case report

Level of Evidence: V, Expert Opinion

Dorsal dislocation of the first metatarsophalangeal joint associated with fractured second metatarsal head

Traumatic dislocations of the first metatarsophalangeal joint were first described by Mouchet in 1931. The anatomical complexity of the first metatarsophalangeal joint makes this injury one of a kind. There have been a limited number of case reports of this injury. The ability to reduce the dislocation by nonoperative measures depends largely on the type of dislocation and involvement of the sesamoid complex. We report a case of a 35-year-old male with complete dorsal dislocation of the first metatarsophalangeal joint with second metatarsal head fracture. On review at 12 months he was pain free, fully mobile and pleased with the result. The papers principle message is that significant injuries to the metatarsophalangeal joint may be associated with fractures of adjacent bone segments, which may change diagnostic and therapeutic approaches. Also, the evolution of patients with this kind of injury after reduction is not well know today, at short, medium and long term. Thus could be considered to be a further development of Jahss's classification.

Hallux, sesamoid, and first metatarsal injuries

Hallux, sesamoid, and first metatarsal injuries are common foot injuries and have implications in the biomechanical functionality of the first ray and foot. They are essential for propulsion in normal gait. As part of the first ray, it is an important contributor to normal locomotion. Any structure disruption or injury can create angular changes or arthritis, which can have biomechanical implications, including pain, disability, compensation, swelling, and reduced range of motion.

Traumatic ipsilateral multiple open metatarsal and calcaneal fractures with first metatarsophalangeal joint dislocation: a case report

A 17-year-old man fell from a height of 10 m onto his right forefoot and sustained ipsilateral calcaneal, comminuted cuboid, and second, third, and fourth metatarsal neck fractures and first metatarsophalangeal joint open dislocation. This report discusses this rare injury. The authors believe that initial debridement with immediate surgical fixation and reduction with appropriate antibiotic treatment saved the patient's extremity.

Traumatic dislocation of the first metatarsophalangeal joint with entrapment of the flexor hallucis longus tendon

A case of traumatic dislocation of the first metatarsophalangeal joint with concomitant fibular sesamoid fracture and thoracic vertebral fracture is presented. The first metatarsophalangeal joint was repaired by means of open reduction with collateral ligament repair. At 12 months following the operation, the patient displayed nonpainful and unrestricted first metatarsophalangeal joint motion.

First metatarsophalangeal joint dislocation with open fracture of tibial and fibular sesamoids

Traumatic dislocations of the first metatarsophalangeal joint were first described by Mouchet in 1931. The anatomical complexity of the first metatarsophalangeal joint makes this injury one of a kind. There have been only been a limited number of case reports of this injury, but none in combination with open fractures of both sesamoids. We would like to report 1 case of an open traumatic dislocation of the first metatarsophalangeal joint with open fracture of the fibular and tibial sesamoid. Open reduction and internal fixation of the injury led to a successful outcome.

Irreducible dorsal subluxation of the first metatarsophalangeal joint: a case report

We report a case of dorsal subluxation of the first metatarsophalangeal joint without dislocation of the sesamoids or destruction of the sesamoid complex. Closed reduction was unsuccessful. At surgery, the subluxation was found to be associated with locking of the abductor hallucis tendon onto the medial condyle of the metatarsal. After restoration of the tendon to its normal anatomic alignment, the joint was successfully reduced. One year after the injury, the patient was asymptomatic and had full range of motion of the metatarsophalangeal joint.

Fracture-dislocation of the first metatarsophalangeal joint: open reduction through a medial incisional approach

A case of traumatic fracture-dislocation of the first metatarsophalangeal joint is reported. This type of injury is extremely rare. The injury was associated with complete disruption of the following anatomic structures: conjoined tendon of abductor hallucis and medial head of flexor hallucis brevis, plantar plate, and the intersesamoid ligament. Additionally, there was a transverse fracture of the tibial sesamoid. Excision of the fractured tibial sesamoid trapped within the joint and primary repair was achieved through a medial incisional approach. A complete description of the repair and rationale for the surgical procedure is discussed.