title: Irreducible metatarsophalangeal joint dislocation of the lesser toes: a case report.
abstract: Irreducible metatarsophalangeal joint dislocation of the lesser toes is a rare injury. We present a 37-year-old man who was injured in a motorcycle accident and dislocated the first to third metatarsophalangeal joints and fractured the fourth metatarsal head. The left first metatarsophalangeal joint was reduced successfully through the closed method, but multiple attempts at closed reduction under local anesthesia failed to reduce the dislocated second and third metatarsophalangeal joints. We performed a dorsal incision between the second and third metatarsals, and the metatarsal heads were found to be entrapped under the plantar plate. Dislocation reduction was performed without damage to the plantar plate, and one Kirschner wire was used to fix the fourth metatarsal head fracture. The pin was removed 8 weeks after surgery, and the patient regained normal gait and returned to work and his previous physical activity level without recurrent dislocation.
authors.affiliation: Department of Orthopaedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Honlok
authors.initials: H
authors.lastname: Lo
authors.forename: Ping-Cheng
authors.initials: PC
authors.lastname: Liu
authors.forename: Po-Chih
authors.initials: PC
authors.lastname: Shen
authors.forename: Shen-Kai
authors.initials: SK
authors.lastname: Chen
authors.forename: Yuh-Min
authors.initials: YM
authors.lastname: Cheng
authors.forename: Cheng-Chang
authors.initials: CC
authors.lastname: Lu
mesh_terms: D000328:Adult; D005592:Fracture Fixation / Q000379:methods*; D050723:Fractures, Bone / Q000150:complications / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000150:complications / Q000601:surgery*; D008297:Male; D008682:Metatarsal Bones / Q000293:injuries* / Q000601:surgery; D008683:Metatarsophalangeal Joint / Q000293:injuries* / Q000601:surgery; D014034:Toes / Q000293:injuries* / Q000601:surgery