Shah Rajiv, Geevarughese Nikku Mathew, Kanani Piyush, Shah Shivam
Department of Orthopaedic, Sunshine Global Hospitals, Vadodara, Gujarat, India.
Department of Paediatric Orthopaedics, Christian Medical College, Vellore, Tamil Nadu, India.
J Orthop Case Rep. 2022 Oct;12(10):1-4. doi: 10.13107/jocr.2022.v12.i10.3340.
Dislocations of lesser metatarsophalangeal joints (MTPJs) following trauma, inflammatory arthritis, and synovitis are not uncommon. Closed reduction is sufficient in most instances. However, if it is not addressed scientifically in the first instance; rarely, a habitual dislocation may result.
We present a case of a 43-year-old male patient with painful habitual dorsal dislocation of the fourth MTPJ following a trivial trauma 2 years back, resulting in an inability to wear closed footwear. The patient was managed with the repair of the plantar plate, excision of the neuroma, and transfer of long flexor to dorsum to act as dynamic check rein. At 3 months, he was able to wear shoes and returned to normal activities. There was no radiographic evidence of arthritis or avascular necrosis at 2 years follow-up, and he was comfortably using closed footwear.
Isolated dislocation of the lesser MTPJs is an uncommon entity. Traditional practice is closed reduction. However, if the reduction is inadequate, open reduction should be performed to prevent chances of recurrence.
创伤、炎性关节炎和滑膜炎后较少见的跖趾关节（MTPJ）脱位并不罕见。在大多数情况下，闭合复位就足够了。然而，如果一开始没有科学地处理；很少会导致习惯性脱位。
我们报告一例43岁男性患者，2年前因轻微创伤后出现第四跖趾关节疼痛性习惯性背侧脱位，导致无法穿封闭式鞋类。该患者接受了跖板修复、神经瘤切除以及长屈肌转移至背侧作为动态制动装置的治疗。3个月时，他能够穿鞋并恢复正常活动。在2年的随访中，没有关节炎或缺血性坏死的影像学证据，并且他能够舒适地穿着封闭式鞋类。
较少见的跖趾关节孤立性脱位是一种不常见的情况。传统做法是闭合复位。然而，如果复位不充分，应进行切开复位以防止复发。
