Rare Case Report of Closed Traumatic Dislocation of Second to Fifth Metatarsophalangeal Joints

Abstract

Closed traumatic dislocation of multiple metatarsophalangeal joints is a rare injury. Until now only one case of simultaneous dislocation of all five metatarsophalangeal joints has been reported in peer-reviewed studies. The complex anatomy of the metatarsophalangeal joints prevents the relocation of the joints in a closed manner in maximum cases. We are reporting a case of dorsal dislocation of the second to fifth metatarsophalangeal joints in the left foot after road traffic accident. Bony prominence over the plantar aspect and increased web space between toes on presentation, then incongruity of metatarsophalangeal joints has to be thoroughly checked on radiograph. Since closed reduction attempts failed open reduction was done through dorsal approach using two incisions. Button holing of the capsule with interposition of capsule and plantar plate was noted. Dorsal approach avoids damage to the plantar plate and surrounding soft tissues.

Open Reduction of 2nd Metatarsophalangeal Joint as a Method to Reduce Combined Lesser Metatarsophalangeal Dislocation – A Case Report

“…Understanding the intricate anatomy of the MTP joints is paramount when addressing MTP joint dislocations, as underscored by our experience in treating the presented case. The MTP joint, characterized as a synovial condyloid type of joint [ 1 ], plays a crucial role in the transverse arch of the foot and contributes significantly to the toe-off phase of the gait cycle [ 2 ]. Movements at these joints are limited to plantar flexion and dorsiflexion.…”

“…Closed combined dislocation of metatarsophalangeal (MTP) joints is a rare occurrence [ 1 - 3 ], with limited case reports in the literature [ 2 , 4 ]. This report presents a unique case of dorsolateral dislocation involving the second, third, and fifth MTP joints, accompanied by a displaced fracture of the fourth metatarsal neck.…”