Abstract
We report a very rare case of bipolar fracture with dislocation of the proximal phalanx or floating proximal phalanx of the toe. The literature has shown that closed reduction gives a lesser chance of success considering the inherent anatomy of the foot. We report a case of a 40-year-old male with an open injury to his right foot involving bipolar dislocation of the proximal phalanx of the third toe with extensor digitorum longus tendon injury and fracture of the neck of the fourth proximal phalanx of the right foot. With the realization that open reduction and Kirschner wire fixation are good options in patients with such a presentation, a prompt and accurate diagnosis with a treatment plan was made, which lead to clinical success.
Highlights
Floating metatarsals are a rare and complex type of injury in the world of trauma to the foot
We report one of the very few cases of bipolar fracture-dislocation of the proximal phalanx or floating proximal phalanx of the toe, as described in the medical literature
We describe a case of bipolar dislocation of proximal phalanx of the toe, where closed reduction failed, resulting in the need for open reduction and Kirschner (K) wire fixation
Summary
Floating metatarsals are a rare and complex type of injury in the world of trauma to the foot. We describe a case of bipolar dislocation of proximal phalanx of the toe, where closed reduction failed, resulting in the need for open reduction and Kirschner (K) wire fixation. The patient presented with an alleged history of road traffic accident, sustaining an open injury to his right foot. It involved the bipolar dislocation of the proximal phalanx of the third toe with extensor digitorum longus tendon injury and fracture of the neck of the fourth proximal phalanx of the right foot. The superficial and deep wound infection never occurred at any point of time This included physical signs (erythema, malodor, gross purulence, etc.) and hematological signs (rising of white blood cell count, erythrocyte sedimentation rate, C-reactive protein etc.). The patient returned to his work with no limitations on the activity or complications after his final followup
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