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Traumatic dislocations of the lesser toes

J A Brunet¹, S Tubin

¹Division of Orthopaedic Surgery, University of Ottawa, Ottawa General Hospital, Ontario, Canada.

Foot & Ankle International

|July 1, 1997

Summary

Traumatic dislocations of lesser metatarsophalangeal joints (DLMTPJ) and lesser interphalangeal joints (DLIPJ) are rare foot injuries. Open reduction is often necessary, especially for DLIPJ, and outcomes depend on associated injuries.

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Area of Science:

Orthopedic surgery
Foot and ankle trauma
Biomechanics of foot injuries

Background:

Traumatic dislocations of the lesser metatarsophalangeal joints (DLMTPJ) and lesser interphalangeal joints (DLIPJ) are infrequent occurrences in orthopedic practice.
Understanding the specific mechanisms and associated injuries is crucial for effective management and patient outcomes.

Observation:

A retrospective analysis reviewed 31 cases alongside 16 previously reported cases of DLMTPJ and DLIPJ.
The primary mechanism identified involves hyperextension with axial loading.
Associated ipsilateral foot fractures or dislocations were frequently observed, impacting treatment and prognosis.

Findings:

Open reduction is frequently required for both DLMTPJ (30%) and DLIPJ (virtually all cases), often due to plantar plate entrapment.
Isolated DLMTPJ dislocations, when treated, generally result in minimal long-term complaints.
DLIPJ dislocations, once reduced, typically lead to pain-free outcomes.

Implications:

Prompt and appropriate surgical intervention, particularly open reduction, is vital for optimal outcomes in DLMTPJ and DLIPJ.
Concomitant displaced ipsilateral midfoot or forefoot injuries significantly complicate recovery and can lead to persistent disability.
Timely treatment of neglected DLMTPJ is essential to prevent ongoing symptoms.

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