Plantar dislocation of the metatarsophalangeal joint: case report

Dislocations of lesser metatarsophalangeal joints are rare and are almost always dorsal hyperextension injuries. The patient reported sustained plantar dislocations of the second and third metatarsophalangeal joints in a motor vehicle accident; the mechanism of injury was hyperflexion. Closed reduction was not possible, and at the time of open reduction, the extensor digitorum longus and brevis tendons to the third toe were trapped beneath the plantar aspect of the third metatarsal head. Once the tendons were retracted dorsomedially, the joint was easily reduced. Fixation with a Kirschner wire was necessary because of joint instability.