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Complex Irreducible Dislocation of the Fourth Toe Proximal Interphalangeal Joint in a 5-year-old Boy Fixed by Soft
Samuel Tin Yan Cheung1, Ashley Wong2, Robert Yun Po Chang3
1Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China.
Introduction:
Irreducible lesser-toe interphalangeal joint dislocation in children is rare, but may cause pain, recurrent dislocations, and soft-tissue injury. The optimal method of fixation remains unclear. We present the first-ever reported case of an irreducible fourth toe proximal interphalangeal joint dislocation in a 5-year-old boy, successfully fixed with JuggerKnot™ soft mini-anchor.
Case Report:
A 5-year-old boy with a crush injury to his left fourth toe, shown persistent dorsolateral dislocation of the proximal interphalangeal joint. Intraoperatively, close reduction failed, and we found a complete tear of the medial collateral ligament to be the culprit of the complex dislocation. It was repaired with the JuggerKnot™ soft mini-anchor and tied down to the proximal phalanx.
Conclusion:
This rare case illustrates the technique of soft mini-anchor in fixing irreducible dislocations with ligamentous injuries. It is safe and effective in children with similar injuries because it is one-staged operation that does not disrupt the growing cartilage and preserves joint motion.
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