An Infrequent Presentation of Open Traumatic Dislocation of Second to Fifth Metatarsophalangeal Joints

Post-traumatic dislocation of multiple adjoining lesser toes is an infrequent presentation. The regional anatomy of the metatarsophalangeal (MTP) joints is such that various structures, primarily the soft tissues such as plantar plate and ligaments, provide hindrance to the closed reduction of the j...

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Main Authors: Tathagath Tiwary, Rajavel Kalirajan, Gowthaman Natarajan
Format: Article
Language:English
Published: Jaypee Brothers Medical Publisher 2025-07-01
Series:Journal of Orthopedics and Joint Surgery
Subjects:
Online Access:https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1183
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author Tathagath Tiwary
Rajavel Kalirajan
Gowthaman Natarajan
author_facet Tathagath Tiwary
Rajavel Kalirajan
Gowthaman Natarajan
author_sort Tathagath Tiwary
collection DOAJ
description Post-traumatic dislocation of multiple adjoining lesser toes is an infrequent presentation. The regional anatomy of the metatarsophalangeal (MTP) joints is such that various structures, primarily the soft tissues such as plantar plate and ligaments, provide hindrance to the closed reduction of the joint. Here, we present a case of open dorsal dislocation of the second to fifth MTP joints in the right foot following a road traffic accident (RTA). The patient came to the emergency room (ER) with a history of RTA resulting in injury to the right foot. On examination, the plantar aspect of the foot had an open wound with protrusion of the underlying bones, giving a “marble ball appearance.” There was an increase in interdigital web space on presentation along with discordance of articulation of MTP joints. All findings were confirmed on radiographs. Multiple closed reduction attempts were made but all were futile. Hence, open relocation was done through the dorsal and plantar approaches by extending the open wound and making three incisions—one dorsally and two on the plantar. Excision of the plantar plate and the joint capsule was done along with K-wire fixation.
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spelling doaj-art-63d96a0f72284dce93d1ae4b28f8befb2025-08-20T03:40:44ZengJaypee Brothers Medical PublisherJournal of Orthopedics and Joint Surgery2582-78632025-07-017229029310.5005/jojs-10079-118322An Infrequent Presentation of Open Traumatic Dislocation of Second to Fifth Metatarsophalangeal JointsTathagath Tiwary0https://orcid.org/0009-0002-3222-9603Rajavel Kalirajan1https://orcid.org/0009-0000-3675-2229Gowthaman Natarajan2https://orcid.org/0009-0002-7492-4946Department of Orthopedics, SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, IndiaDepartment of Orthopedics, SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, IndiaGowthaman Natarajan, Department of Orthopedics, SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India, Phone: +91 9715825098Post-traumatic dislocation of multiple adjoining lesser toes is an infrequent presentation. The regional anatomy of the metatarsophalangeal (MTP) joints is such that various structures, primarily the soft tissues such as plantar plate and ligaments, provide hindrance to the closed reduction of the joint. Here, we present a case of open dorsal dislocation of the second to fifth MTP joints in the right foot following a road traffic accident (RTA). The patient came to the emergency room (ER) with a history of RTA resulting in injury to the right foot. On examination, the plantar aspect of the foot had an open wound with protrusion of the underlying bones, giving a “marble ball appearance.” There was an increase in interdigital web space on presentation along with discordance of articulation of MTP joints. All findings were confirmed on radiographs. Multiple closed reduction attempts were made but all were futile. Hence, open relocation was done through the dorsal and plantar approaches by extending the open wound and making three incisions—one dorsally and two on the plantar. Excision of the plantar plate and the joint capsule was done along with K-wire fixation.https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1183case reportdislocationfoot and ankle surgerymetatarsophalangeal jointorthopedic trauma surgeryorthopedicstrauma
spellingShingle Tathagath Tiwary
Rajavel Kalirajan
Gowthaman Natarajan
An Infrequent Presentation of Open Traumatic Dislocation of Second to Fifth Metatarsophalangeal Joints
Journal of Orthopedics and Joint Surgery
case report
dislocation
foot and ankle surgery
metatarsophalangeal joint
orthopedic trauma surgery
orthopedics
trauma
title An Infrequent Presentation of Open Traumatic Dislocation of Second to Fifth Metatarsophalangeal Joints
title_full An Infrequent Presentation of Open Traumatic Dislocation of Second to Fifth Metatarsophalangeal Joints
title_fullStr An Infrequent Presentation of Open Traumatic Dislocation of Second to Fifth Metatarsophalangeal Joints
title_full_unstemmed An Infrequent Presentation of Open Traumatic Dislocation of Second to Fifth Metatarsophalangeal Joints
title_short An Infrequent Presentation of Open Traumatic Dislocation of Second to Fifth Metatarsophalangeal Joints
title_sort infrequent presentation of open traumatic dislocation of second to fifth metatarsophalangeal joints
topic case report
dislocation
foot and ankle surgery
metatarsophalangeal joint
orthopedic trauma surgery
orthopedics
trauma
url https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1183
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