Jahss type one posterior first metatarsophalangeal dislocation treated with open reduction without fixation: A case report

Younis, Ahmed Saeed; Michael, Fady; Reda, Y.; Hamdy, Moheeb

doi:10.1016/j.tcr.2017.10.020

Cited by 6 publications

(6 citation statements)

References 14 publications

(24 reference statements)

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“…Unexpectedly, in this case report, an unreducible sesamoid dislocation after closed reduction of the first MTP joint was observed. There is no consensus concerning the optimal treatment protocol of these injuries 14,15 . However, when acute first MTP joint dorsal dislocation is associated with a widening of sesamoid complex, a closed reduction should be performed 14,15 .…”

Section: Discussionmentioning

confidence: 99%

First Metatarsal Headphones-Like Lesion

Mazzotti,

Cassanelli,

Artioli

et al. 2024

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Case: A 34-year-old woman sustained a direct trauma to the left hallux during a fall. Radiographs showed a dorsal dislocation of the first metatarsophalangeal joint and a wide separation of sesamoid complex. Closed reduction was tried: postreduction radiographs displayed reduction of first metatarsophalangeal joint and a complete sesamoid complex dislocation. The patient was scheduled for surgery. Through a medial approach, open reduction together with plantar structures release and repair were performed. Functional and radiographic outcomes were satisfactory at the last follow-up. Conclusion: In case of a “headphones-like lesion” surgery is required, together with plantar structures repair.

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Section: Discussionmentioning

confidence: 99%

First Metatarsal Headphones-Like Lesion

Mazzotti,

Cassanelli,

Artioli

et al. 2024

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“…Various surgical approaches have been described in the literature. One technique by Younis et al involves an open reduction with intact collateral ligaments: using a dorsal approach to the dislocated toe the surgeon will apply axial traction and use a Blunt Hohmann retractor from under the intersesamoid ligament on the head of the first metatarsal to lever the proximal phalanx back into its place on the head of the first metatarsal [ 10 ]. After reduction, the toes are tested and if unstable, K-wire fixation is needed.…”

Section: Discussionmentioning

confidence: 99%

Dorsal Dislocation of the First and Second Metatarsophalangeal Joint: A Case Report and Literature Review

Bassil,

Nader,

Lajmi

et al. 2023

Cureus

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Dorsal dislocation of the toes is an infrequent injury that can result in severe pain and deformity. Timely diagnosis and appropriate management are paramount for optimizing patient outcomes. This case report illustrates a 53-year-old male patient who suffered dorsal dislocation of the first and second metatarsophalangeal (MTP) joints due to a crush injury. We present the clinical manifestation, radiographic findings, and management approach for this unique isolated first and second ray MTP joint dorsal dislocation, without any associated fractures. This case report underscores several critical observations: firstly, hallux dorsal dislocation can potentially coincide with other injuries; secondly, it can stem from crushing trauma to the big toe; and thirdly, successful closed reduction, when followed by effective immobilization and early rehabilitation, can yield outstanding outcomes. Additionally, the report emphasizes the importance of pursuing another closed reduction attempt under general anesthesia, if the initial attempt in the emergency room proves unsuccessful, before contemplating open reduction.

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“…La clasifi cación de Jahss, realizada en 1980, es utilizada para las luxaciones posteriores, siendo éstas las más comunes, habla del compromiso del complejo óseo sesamoideo y ligamentario, 5 presenta tres tipos: el tipo I no compromete ninguno de los dos componentes; el tipo IIA contiene el desgarro del ligamento intersesamoideo; el IIB la fractura de los sesamoideos; el IIC reúne la ruptura ligamentaria y la lesión ósea; recientemente se añadió la tipo IIIA en la que existe una rotura completa de la placa plantar de la falange proximal sin fractura sesamoidea; y la tipo IIIB que tiene una interrupción completa de la placa plantar con fractura de los sesamoideos. 5 En las imágenes radiográfi cas realizadas en nuestro caso, se observó la separación de los sesamoideos, lo que nos llevó a concluir una posible ruptura del ligamento intersesamoideo y que, posteriormente, fue comprobado de manera intraoperatoria, lo cual pertenece a una clasifi cación IIA. De acuerdo con la literatura, el mane- www.medigraphic.org.mx jo de este tipo de lesiones podría ser con reducción cerrada, siendo necesaria la intervención quirúrgica en caso de requerir la reparación ligamentaria; sin embargo, por el tiempo de evolución de nuestro paciente, fue necesario realizar una artrodesis con placa condilar y tornillos interfragmentarios para mantener la reducción y consecuente alineación articular.…”

Section: Discussionunclassified