Irreducible fifth metatarsophalangeal joint after car crush injury

Neglected Metatarsophalangeal Joint Dislocation of the Lesser Toe with Associated Metatarsal Fracture Malunion in a 4-Year-Old Child: A Case Report

CASE

A 4-year-old girl presented with a 5-week-old, neglected fourth metatarsophalangeal (MTP) joint dislocation with malunion of the fourth metatarsal. A previous attempt at closed reduction had failed. The reduction was hindered by dynamic stabilizing of soft tissues around the MTP joint. Open reduction of the fourth MTP joint dislocation and corrective osteotomy of the fourth metatarsal was performed. The patient was pain-free without any cosmetic deformity at the 1-year follow-up.

CONCLUSION

Prompt recognition of a MTP dislocation is vital. The long extensor tendon to the toe can hinder the closed reduction of the MTP dislocation. Osteotomy of the metatarsal malunion is necessary for stable reduction.

LEVEL OF EVIDENCE

4.

Metatarsal Shaft Fracture with Associated Metatarsophalangeal Joint Dislocation

Metatarsophalangeal joint dislocations of lesser toes are often seen in the setting of severe claw toes. Traumatic irreducible dislocations have been reported in rare cases following both low-energy and high-energy injuries to the forefoot. In this case report, I present a previously unreported association of a metatarsal shaft fracture with metatarsophalangeal joint dislocation of a lesser toe.