Limits...
Irreducible dislocation of the great toe interphalangeal joint secondary to an incarcerated sesamoid.

Bin Abd Razak HR, Chia ZY, Tan HC - Case Rep Orthop (2015)

Bottom Line: Incarceration of the sesamoid became a block to manipulation and reduction at the specialist outpatient clinic 3 weeks later.The operative course was uneventful.At 6 months after surgery, the patient could walk, run, and return to sports.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, Outram Road, Singapore 169608.

ABSTRACT
Irreducible dorsal dislocation of the interphalangeal (IP) joint of the great toe is rare. We report a case of a 29-year-old gentleman who presented to the Orthopaedic Surgery Specialist Outpatient Clinic with an irreducible IP joint of the great toe that had been untreated for 4 weeks. The mechanism of injury is believed to be a combination of axial loading with a hyperdorsiflexion force when the patient fell foot first into a drain. As the patient did not report severe symptoms and a true lateral radiograph was not ordered, the dislocation was missed initially at the emergency department. The patient had continued to run and play field hockey prior to visiting us. Incarceration of the sesamoid became a block to manipulation and reduction at the specialist outpatient clinic 3 weeks later. The patient was treated with open surgical exploration, resection of the interposed sesamoid, and Kirschner-wire fixation of the IP joint followed by occupational therapy for mobilization exercises. The operative course was uneventful. At 6 months after surgery, the patient could walk, run, and return to sports.

No MeSH data available.


Related in: MedlinePlus

These are the radiographs obtained 2 weeks postoperatively showing an enlocated IP joint of the left great toe with the Kirschner-wire well placed.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4385599&req=5

fig5: These are the radiographs obtained 2 weeks postoperatively showing an enlocated IP joint of the left great toe with the Kirschner-wire well placed.

Mentions: The patient was followed up at the Specialist Outpatient Clinic at 2 weeks, 4 weeks, and 6 weeks postoperatively with serial radiographs to ensure enlocation of the left great toe IP joint and to monitor surgical complications. The patient remained well and radiographs showed an enlocated IP joint (Figure 5). The Kirschner-wire was removed in the clinic at 6 weeks postoperatively. The patient was then prescribed with occupational therapy to improve the expected residual stiffness. Subsequently, the patient was seen at 3 months and 6 months postoperatively. He had returned to sports and was symptom-free at the last consult.


Irreducible dislocation of the great toe interphalangeal joint secondary to an incarcerated sesamoid.

Bin Abd Razak HR, Chia ZY, Tan HC - Case Rep Orthop (2015)

These are the radiographs obtained 2 weeks postoperatively showing an enlocated IP joint of the left great toe with the Kirschner-wire well placed.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4385599&req=5

fig5: These are the radiographs obtained 2 weeks postoperatively showing an enlocated IP joint of the left great toe with the Kirschner-wire well placed.
Mentions: The patient was followed up at the Specialist Outpatient Clinic at 2 weeks, 4 weeks, and 6 weeks postoperatively with serial radiographs to ensure enlocation of the left great toe IP joint and to monitor surgical complications. The patient remained well and radiographs showed an enlocated IP joint (Figure 5). The Kirschner-wire was removed in the clinic at 6 weeks postoperatively. The patient was then prescribed with occupational therapy to improve the expected residual stiffness. Subsequently, the patient was seen at 3 months and 6 months postoperatively. He had returned to sports and was symptom-free at the last consult.

Bottom Line: Incarceration of the sesamoid became a block to manipulation and reduction at the specialist outpatient clinic 3 weeks later.The operative course was uneventful.At 6 months after surgery, the patient could walk, run, and return to sports.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, Outram Road, Singapore 169608.

ABSTRACT
Irreducible dorsal dislocation of the interphalangeal (IP) joint of the great toe is rare. We report a case of a 29-year-old gentleman who presented to the Orthopaedic Surgery Specialist Outpatient Clinic with an irreducible IP joint of the great toe that had been untreated for 4 weeks. The mechanism of injury is believed to be a combination of axial loading with a hyperdorsiflexion force when the patient fell foot first into a drain. As the patient did not report severe symptoms and a true lateral radiograph was not ordered, the dislocation was missed initially at the emergency department. The patient had continued to run and play field hockey prior to visiting us. Incarceration of the sesamoid became a block to manipulation and reduction at the specialist outpatient clinic 3 weeks later. The patient was treated with open surgical exploration, resection of the interposed sesamoid, and Kirschner-wire fixation of the IP joint followed by occupational therapy for mobilization exercises. The operative course was uneventful. At 6 months after surgery, the patient could walk, run, and return to sports.

No MeSH data available.


Related in: MedlinePlus