Plantar dislocation of the first metatarsophalangeal joint during lactation

Abstract

Plantar dislocation of the metatarsophalangeal joint of the great toe is a rare injury. We report one example which occurred in a lactating lady following minor trauma, and which was successfully treated by closed manipulation. There was no evidence of major generalised ligamentous laxity.

Incarcerated Plantar Dislocation of the First Metatarsophalangeal Joint: Reduction Using Intra-articular Saline Injection

“…In contrast to the well-developed body of literature surrounding dorsal dislocation of the first MTP joint, [1][2][3][4][5][6] little is known regarding the pathomechanics and management of dislocation of the first MTP joint in the plantar direction. [7][8][9][10][11] A review of the literature reveals only four documented first MTP joint plantar dislocations. [7][8][9]11 First, Biyani et al 9 reported on a patient with severe open fracture-dislocations of all 5 MTP joints in the plantar direction associated with major trauma.…”

“…[7][8][9][10][11] A review of the literature reveals only four documented first MTP joint plantar dislocations. [7][8][9]11 First, Biyani et al 9 reported on a patient with severe open fracture-dislocations of all 5 MTP joints in the plantar direction associated with major trauma. Second, Sarban et al 11 reported on a 3-month-neglected plantar dislocation of the first MTP joint in a patient with bilateral postaxial polydactyly.…”

“…Second, Sarban et al 11 reported on a 3-month-neglected plantar dislocation of the first MTP joint in a patient with bilateral postaxial polydactyly. However, only 2 groups of authors have reported on plantar dislocations of the MTP joint that presented acute and closed, 7,8 and only one of these occurred in an otherwise healthy foot. 8 Specifically, in 1995, Garcia Mata et al 7 reported on a lactating female who sustained an acute plantar dislocation of the first MTP joint with only minor trauma.…”

“…However, only 2 groups of authors have reported on plantar dislocations of the MTP joint that presented acute and closed, 7,8 and only one of these occurred in an otherwise healthy foot. 8 Specifically, in 1995, Garcia Mata et al 7 reported on a lactating female who sustained an acute plantar dislocation of the first MTP joint with only minor trauma. The dislocation was felt to be due to hyperlaxity associated with increased progesterone in the lactating state.…”

“…Much less is known regarding dislocation of the MTP joint plantarly. 1 Indeed, only 2 acute closed plantar dislocations of the MTP joint have been reported, 7,8 and only one of these occurred in an otherwise healthy foot. 8 Because both were reduced by closed manipulation, a classification system developed by Zrig et al 1 in 2017 suggested that acute plantar dislocation of the first MTP joint should be reducible by simple closed manipulation.…”