Closed reduction of a rare type III dislocation of the first metatarsophalangeal joint.
OBJECTIVE
To discuss a rare Type III dislocation of the first metatarsophalangeal (MP) joint, without fracture, that used a closed reduction technique for correction.


METHODS
A 43-yr-old man suffered from an acute severe dislocation of his great toe as the result of acute forceful motion applied to the toe as his foot was depressed onto a brake pedal to avoid a motor vehicle accident. Physical examination and X-rays revealed the dislocation, muscle spasm, edema and severely restricted range of motion.


RESULTS
The dislocation was corrected using a closed reduction technique, in this case a chiropractic manipulation. Fourteen months after reduction, the joint was intact, muscle strength was graded +5 normal, ranges of motion were within normal limits and no crepitation was noted. X-rays revealed normal intact joint congruency. The patient experienced full weight bearing, range of motion and function of the joint.


CONCLUSIONS
Although a Type III dislocation of the great toe has only once been cited briefly in the literature, this classification carries a recommended surgical treatment protocol for correction. No literature describes a closed reduction of a Type III dislocation as described in this case report. It is apparent that a closed reduction technique using a chiropractic manipulation may be considered a valid alternative correction technique for Type III dislocations of the great toe.
Tondera
E K
EK
Texas Chiropractic College, Pasadena, USA.
Baker
C C
CC
D000328:Adult; D001642:Bicycling / Q000293:injuries; D002684:Chiropractic / Q000379:methods*; D006214:Hallux; D006801:Humans; D004204:Joint Dislocations / Q000145:classification / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008683:Metatarsophalangeal Joint / Q000293:injuries*; D011859:Radiography; D016059:Range of Motion, Articular