Lateral Dislocation of the First Metatarsophalangeal Joint: A Case Report

Yeong-Sik Yun; Young-Mo Kim; Kyung-Cheon Kim; Pil-Sung Kim

doi:10.12671/jkfs.2008.21.4.312

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Yun, Kim, Kim, and Kim: Lateral Dislocation of the First Metatarsophalangeal Joint: A Case Report

Case Report

Journal of the Korean Fracture Society 2008; 21(4): 312-315.

Published online: 31 October 2008

DOI: https://doi.org/10.12671/jkfs.2008.21.4.312

Lateral Dislocation of the First Metatarsophalangeal Joint: A Case Report

Yeong-Sik Yun, M.D.^*, Young-Mo Kim, M.D., Kyung-Cheon Kim, M.D., Pil-Sung Kim, M.D.

Department of Orthopedic Surgery, School of Medicine, Chungnam National University, Daejeon, Korea.

^*Department of Orthopedic Surgery, Saeson Clinic, Daejeon, Korea.

Address reprint requests to: Young-Mo Kim, M.D. Department of Orthopedic Surgery, School of Medicine, Chungnam National University, 640, Daesa-dong, Jung-gu, Daejeon 301-721, Korea. Tel: 82-42-280-7352, Fax: 82-42-252-7098, osdr69@cnu.ac.kr

Received 15 May 2008 Revised 23 July 2008 Accepted 10 October 2008

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Dislocation of the metatarsophalangeal joint is rare due to the stability of the ligaments and soft tissue surrounding the joint. The authors have experienced lateral dislocation of the first metatarsophalangeal joint, which required surgery, accompanied by complete injuries of medial collateral ligament and capsule, contributing to medial stability, differing from posterior dislocation with intersesamoid complex rupture, with a review of the relevant literature and previous reported cases.

Keywords: First metatarsophalangeal joint, Lateral dislocation

Figures and Tables

Fig. 1

(A) The plain AP radiography showed that the first metatarsophalangeal joint was dislocated and the proximal phalanx was displaced laterally. Also, the space between the first and second metatarsal bone was widened and there was a small avulsive fragment on the medial collateral ligament.

(B) In lateral view, the base of proximal phalanx of the greater toe was overlapped with the head of the first metatarsal bone without dorsal or plantar displacement.

Fig. 2

(A) After closed reduction, valgus stress radiography showed avulsive bone fragment of the proximal phalanx and medial instability of metatarsophalangeal joint.

(B) MRI showed that the intersesamoidal ligment (space between arrows) were intact.

Fig. 3

(A) An operative finding. The medial collateral ligament (white arrow) was avulsive from the base of the proximal phalanx and the tendon of abductor hallucis (black arrow) was ruptured.

(B) The temporary internal fixation of the first metatarsophalangeal joint was done using K-wire.

References

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