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第二至第五跖趾关节闭合性创伤性脱位罕见病例报告

Rare Case Report of Closed Traumatic Dislocation of Second to Fifth Metatarsophalangeal Joints.

作者信息

Raj Santhosh, Subramani Suresh, Babar Suraj J, Balaji Muthukumar S, Anand Vijay

机构信息

Department of Orthopaedics, SRM Medical College Hospital and Research Centre, Chennai, IND.

出版信息

Cureus. 2020 Nov 28;12(11):e11745. doi: 10.7759/cureus.11745.

Abstract

Closed traumatic dislocation of multiple metatarsophalangeal joints is a rare injury. Until now only one case of simultaneous dislocation of all five metatarsophalangeal joints has been reported in peer-reviewed studies. The complex anatomy of the metatarsophalangeal joints prevents the relocation of the joints in a closed manner in maximum cases. We are reporting a case of dorsal dislocation of the second to fifth metatarsophalangeal joints in the left foot after road traffic accident. Bony prominence over the plantar aspect and increased web space between toes on presentation, then incongruity of metatarsophalangeal joints has to be thoroughly checked on radiograph. Since closed reduction attempts failed open reduction was done through dorsal approach using two incisions. Button holing of the capsule with interposition of capsule and plantar plate was noted. Dorsal approach avoids damage to the plantar plate and surrounding soft tissues.

摘要

多发性跖趾关节闭合性创伤性脱位是一种罕见的损伤。到目前为止,在同行评审的研究中仅报道过一例所有五个跖趾关节同时脱位的病例。跖趾关节复杂的解剖结构使得在大多数情况下无法以闭合方式使关节复位。我们报告一例道路交通事故后左足第二至第五跖趾关节背侧脱位的病例。就诊时可见足底有骨性突出且趾间间隙增宽,随后必须通过X线片仔细检查跖趾关节的不匹配情况。由于闭合复位尝试失败,遂采用背侧入路经两个切口进行切开复位。术中发现关节囊纽扣孔形成,伴有关节囊和跖板嵌入。背侧入路可避免损伤跖板及周围软组织。

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本文引用的文献

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Irreducible dislocation of all the lesser metatarsophalangeal joints of the foot: a case report.
Foot Ankle Spec. 2012 Oct;5(5):324-6. doi: 10.1177/1938640012457940. Epub 2012 Aug 30.
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Dislocation of all metatarsophalangeal joints caused by horse injury.
J Trauma. 2007 Oct;63(4):938-9. doi: 10.1097/01.ta.0000235280.94471.e9.
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Presentation of a missed injury of a metatarsophalangeal joint dislocation in the lesser toes.
J Trauma. 2001 Jun;50(6):1150-2. doi: 10.1097/00005373-200106000-00029.

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