Abstract
Traumatic dislocation of a lesser metatarsophalangeal (MTP) joint is a rare case for a foot and ankle surgeon to encounter. These dislocations can be difficult to reduce due to the surrounding connective tissues that may be interposed in the joint space. These include the plantar plate, deep transverse metatarsal ligament, flexor tendons, and lumbricals. When the clinician is unable to reduce the phalanx, surgery is required to prevent sequelae such as further swelling, ecchymosis, joint damage, and impingement of the neurovascular bundle. In this case report, we present the case of a 53-year-old female who suffered a traumatic dislocation after a low-energy trip and fall injury.
Highlights
Dislocation of the metatarsophalangeal (MTP) joint is an uncommon injury
These dislocations can be difficult to reduce due to the surrounding connective tissues that may be interposed in the joint space
We present the case of a 53-year-old female who suffered a traumatic dislocation after a low-energy trip and fall injury
Summary
Dislocation of the metatarsophalangeal (MTP) joint is an uncommon injury. It is usually due to high energy impact directed at the base of the joint [1]. A Magnetic Resonance Imaging (MRI) study was ordered, revealing a dislocated third MTP joint and associated plantar plate tear She went back to the urgent care clinic where multiple unsuccessful attempts were made to reduce the dislocated third MTP joint. At 3 weeks post-injury, she presented to our office She was full-weight-bearing in a walking boot with swelling, tenderness, and decreased motion of her third MTP joint. At 3-month follow-up, the toe was still reduced, albeit with subtle radiographic lateral subluxation She still had pain of 2 out of 10 on the Visual Analog Scale (VAS) and still had some hypersensitivity of the incision, which we attributed to digital nerve irritation. She is using a custom metatarsal pad orthotic and avoiding barefoot walking or high impact activity until she can lose some weight
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