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First and Second Metatarsophalangeal Joint Open Dislocations: A Case Report
A Sharma1, R Dosajh1, G S Bedi1
1Department of Orthopaedics, Government Multispecialty Hospital, Chandigarh, India.
Malaysian Orthopaedic Journal
|April 25, 2017
Summary
Multiple metatarsophalangeal joint dislocations are rare, often caused by high-energy hyperextension. This case highlights a successful open reduction for simultaneous 1st and 2nd MTP joint dislocations using a plantar approach.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Foot and Ankle Surgery
Background:
- Multiple metatarsophalangeal (MTP) joint dislocations are uncommon injuries.
- They typically result from high-energy trauma causing hyperextension of the MTP joint.
- This mechanism can lead to avulsion of the plantar capsule, making closed reduction difficult if collateral ligaments remain intact.
Observation:
- A case of simultaneous open dislocation of the 1st and 2nd MTP joints is presented.
- The injury involved acute hyperextension, leading to a locked fibrocartilaginous plate over the metatarsal heads.
- A plantar approach was utilized, leveraging an existing plantar wound for surgical access.
Findings:
- Successful open reduction of the simultaneous 1st and 2nd MTP joint dislocations was achieved.
- Post-operative follow-up at 18 months showed no redislocations.
- No signs of avascular necrosis of the metatarsal heads were observed.
Implications:
- The plantar approach can be an effective surgical strategy for complex MTP joint dislocations.
- This case demonstrates a viable treatment option for rare, high-energy MTP joint injuries.
- Successful surgical management can lead to good long-term outcomes, preventing recurrence and avascular necrosis.
