Sharma A, Dosajh R, Bedi G S, Gupta K, Jain A
Department of Orthopaedics, Government Multispecialty Hospital, Chandigarh, India.
Malays Orthop J. 2017 Mar;11(1):71-73. doi: 10.5704/MOJ.1703.010.
Dislocation of multiple metatarsophalangeal joint is an uncommon injury. The mechanism of injury is a high energy force distal to proximal with foot in hyperextension at the metatarsophalangeal (MTP) joint. The acute hyperextension of the toe at the moment of injury causes avulsion of the plantar part of the capsule from the junction of head and neck of the metatarsal. If the collateral ligaments remain intact, they maintain the locked fibrocartilaginous plate over the dorsum of the head of the metatarsal, making closed reduction impossible. We report a case of simultaneous 1st and 2nd MTP joint open dislocation. In the present case, we chose the plantar approach utilizing the already present plantar wound. At 18 months post-operative follow-up, there was no instance of redislocations or signs of avascular necrosis of head of metatarsal.
多发跖趾关节脱位是一种罕见的损伤。损伤机制是在跖趾（MTP）关节处足部处于过伸位时，由远至近的高能量暴力。损伤瞬间脚趾的急性过伸导致跖骨头与颈部交界处关节囊跖侧部分撕脱。如果侧副韧带保持完整，它们会维持跖骨头背侧锁定的纤维软骨板，使得闭合复位无法进行。我们报告一例第1和第2跖趾关节同时开放性脱位的病例。在本病例中，我们利用已有的足底伤口选择了足底入路。术后18个月随访时，没有再脱位情况，也没有跖骨头缺血性坏死的迹象。
