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Irreducible Metatarsophalangeal Joint Dislocation of the Lesser Toes

A Case Report

Honlok Lo Department of Orthopaedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

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Ping-Cheng Liu Department of Orthopaedic Surgery, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

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Po-Chih Shen Department of Orthopaedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

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Shen-Kai Chen Department of Orthopaedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

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Yuh-Min Cheng Department of Orthopaedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

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Cheng-Chang Lu Department of Orthopaedic Surgery, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

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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. (J Am Podiatr Med Assoc 103(3): 236–240, 2013)

Corresponding author: Cheng-Chang Lu, MD, Department of Orthopaedic Surgery, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, 482, Shan-Ming Road, Hsiao-Kang District, Kaohsiung 812, Taiwan. (E-mail: 0880330@kmhk.kmu.edu.tw)
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