Elsevier

The Journal of Foot and Ankle Surgery

Volume 50, Issue 5, September–October 2011, Pages 580-584
The Journal of Foot and Ankle Surgery

Case Reports and Series
Interphalangeal Dislocation of Toes: A Retrospective Case Series and Review of the Literature

https://doi.org/10.1053/j.jfas.2011.04.032Get rights and content

Abstract

Although not uncommon, dislocation of the toes, including that of the great toe, is not commonly reported in published studies. In the present report, we describe a series of 18 patients with toe dislocations managed by our department from January 2001 to December 2007. We considered the radiographic pattern of injury in our series of patients. Of the 18 patients, 10 (55.56%) had their toe dislocations treated by closed reduction with or without internal fixation. Seven patients (38.89%) with complex dislocation, defined as open dislocation or dislocation not amenable to (failed attempt) closed reduction, that required open reduction and internal fixation. One patient (5.56%) with a dislocated toe declined to undergo any form of treatment.

Section snippets

Patients and Methods

Patients with “International Classification of Diseases, Ninth Version, Clinical Modification” diagnostic code (code 838.09, dislocation of toe/great toe) were eligible for inclusion in our retrospective case series. We performed a diagnostic code search through our hospital electronic in-patient record system under the established diagnostic code 838.09 and recruited 18 patients under this code. Their in-patient and outpatient records and plain digital radiographs were reviewed and analyzed.

Results

A total of 18 patients with IPJ dislocations of the toes were identified and are summarized in Table 1. Of the 18 patients, 8 (44.44%) sustained their proximal IPJ (PIPJ) dislocation on landing and 6 (33.33%) sustained an injury as a result of kicking an object. Only 2 patients (11.11%) were injured by a crush injury; 2 other patients (11.11%) had an unknown injury mechanism. These 3 different classifications have a similar type of mechanism of injury. In our experience, we found that most

Discussion

As simple as the diagnosis and treatment of this injury might seem, these 18 patients were referred to us because of unsuccessful reduction. We believe that a better understanding of the underlying injury mechanism can help us treat this rare, easily treatable but often maltreated, injury. It has been theorized that the injury mechanism is hyperextension and abduction 3, 5, 6, 7, 8; hence, reduction by simple traction often fails because the plantar plate is trapped inside the joint. The

References (12)

  • DeLee JC. Fractures and dislocations of the foot, in Surgery of the Foot, edited by RA Mann, ed. 5, pp 807-808, CV...
  • DeLee JC. Fractures and dislocations of the foot, in Surgery of the Foot, edited by RA Mann, pp 1701-1703, Mosby Year...
  • M. Katayama et al.

    Irreducible dorsal dislocation of the toe

    J Bone Joint Surg (Am)

    (1988)
  • Myerson MS. Injuries to the forefoot and toes, in Disorders of the Foot and Ankle, pp 2268-2269, edited by MH Jahss, WB...
  • M.H. Jahss

    Chronic and recurrent dislocations of the fifth toe

    Foot Ankle

    (1981)
  • T.L. Nelson et al.

    Irreducible dorsal dislocation of the interphalangeal joint of the great toe

    Clin Orthop

    (1981)
There are more references available in the full text version of this article.

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Conflict of Interest: None reported.

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