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