Case Report

A Open Hallux Interphalangeal Joint Dislocation: A Rare Case

Abstract

Background: The interphalangeal (IP) joint dislocation of hallux is a rare occurrence probably due to the presence of strong ligamentous attachments around it. Closed reduction of this kind of dislocation proves to be unsatisfactory. Herein, we are presenting a case of an open dorsomedial type of IP joint dislocation following a road traffic accident.

Case Report: A 36-year-old woman with injury to her right great toe following a road traffic accident presented in the casualty of Chettinad Hospital, Kelambakkam, India. On examination, there was a 3 × 2 cm laceration present over the medial-plantar aspect. The bone was exposed. Hallux varus deformity was noted due to the dislocation of the IP joint. The reduction of IP joint dislocation was quite unstable and was fixed with two 1mm Kirschner wires (K-wires) under fluoroscopic guidance. The patient was sequentially followed up on the 4th and 6th weeks post-op. Joint integrity and stability were assessed which were found to be satisfactory after the removal of K-wire on the 6th week post-op.

Conclusion: Open IP dislocations of the hallux Miki type 2 are unstable types of injury to deal with. Closed reduction in these injuries is difficult owing to the impinging sesamoid bone along with other soft tissues. These types of injuries should be reduced and fixed with K-wires to have better stability followed by long-term immobilization of around 3 to 4 weeks.

1. Jahss MH. Stubbing injuries to the hallux. Foot Ankle. 1981;1(6):327-32. doi: 10.1177/107110078100100605. [PubMed: 7349859].
2. Wolfe J, Goodhart C. Irreducible dislocation of the great toe following a sports injury. A case report. Am J Sports Med. 1989;17(5):695-6. doi: 10.1177/036354658901700520. [PubMed: 2610289].
3. Miki T, Yamamuro T, Kitai T. An irreducible dislocation of the great toe. Report of two cases and review of the literature. Clin Orthop Relat Res. 1988;(230):200-6. [PubMed: 3284677].
4. Hatori M, Goto M, Tanaka K, Smith RA, Kokubun S. Neglected irreducible dislocation of the interphalangeal joint of the great toe: A case report. J Foot Ankle Surg. 2006;45(4):271-4. doi: 10.1053/j.jfas.2006.04.011. [PubMed: 16818156].
5. Yang IB, Sun KK, Sha WL, Yu KS, Chow YY. Interphalangeal dislocation of toes: A retrospective case series and review of the literature. J Foot Ankle Surg. 2011;50(5):580-4. doi: 10.1053/j.jfas.2011.04.032. [PubMed: 21621431].
6. Yasuda T, Fujio K, Tamura K. Irreducible dorsal dislocation of the interphalangeal joint of the great toe: Report of two cases. Foot Ankle. 1990;10(6):331-6. doi: 10.1177/107110079001000608. [PubMed: 2358262].
7. Barnett JC, Crespo A, Daniels VC. Intra-articular accessory sesamoid dislocation of the great toe. Report of case. J Fla Med Assoc. 1979;66(6):613-5. [PubMed: 512620].
8. Muller GM. Dislocation of sesamoid of hallux. The Lancet.
1994;243(6303):789. doi: 10.1016/S0140-6736(00)77772-5.
9. Crosby LA, McClellan JW, Prochaska VJ. Irreducible dorsal dislocation of the great toe interphalangeal joint: Case report and literature review. Foot Ankle Int. 1995;16(9):559-61. doi: 10.1177/107110079501600908. [PubMed: 8563924].
10. Suwannahoy P, Srisuwan T, Pattamapaspong N, Mahakkanukrauh P. Intra-articular ossicle in interphalangeal joint of the great toe and clinical implication. Surg Radiol Anat. 2012;34(1):39-42. doi: 10.1007/s00276-011-0830-x. [PubMed: 21626274].
11. Leung HB, Wong WC. Irreducible dislocation of the hallucal interphalangeal joint. Hong Kong Med J. 2002;8(4):295-9. [PubMed: 12167736].
Files
IssueVol 9 No 3 (2023) QRcode
SectionCase Report
DOI https://doi.org/10.18502/jost.v9i3.13037
Keywords
Hallux Interphalangeal Joint Dislocation Miki Type Case Study

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Kothimbakkam PK, Chandru A, Anantharamakrishnan G, Murugesan V. A Open Hallux Interphalangeal Joint Dislocation: A Rare Case. J Orthop Spine Trauma. 2023;9(3):146-8.