The Mechanics of Conservative Treatment

A Case of Simultaneous Traumatic Dorsal Dislocation of All Five Metatarsophalangeal Joints Treated Successfully With Closed Reduction

“…We applied Sir John Charnley's classic method for closed reduction of dislocations in the present patient by performing hyperdorsiflexion of the toe and applying just enough traction to free the inferior rim of the phalanx from impingement on the dorsal surface of the metatarsal, followed by plantar translation of the phalanx (8). Open reduction will be necessary in a large proportion of MTPJ dislocations and can be performed using a longitudinal dorsal approach, with division of the extensor tendon in a Z fashion, capsulotomy, and reduction without dividing the plantar plate, when required.…”