Brunet J A, Tubin S
Division of Orthopaedic Surgery, University of Ottawa, Ottawa General Hospital, Ontario, Canada.
Foot Ankle Int. 1997 Jul;18(7):406-11. doi: 10.1177/107110079701800706.
Traumatic dislocations of lesser metatarsophalangeal joints (DLMTPJ) and lesser interphalangeal joints (DLIPJ) are very uncommon. A retrospective analysis of 31 cases and of the 16 reported cases was conducted to clarify our understanding of the pathomechanics, the role of associated injuries, recommended treatment, and outcome. Hyperextension with axial loading produces the injuries. Ipsilateral foot fractures or dislocations often occur and thus may compromise the outcome. Thirty percent of DLMTPJ and virtually all DLIPJ require open reduction; most often, the plantar plate prevents closed treatment of either DLMTPJ or DLIPJ. At follow-up, treated isolated DLMTPJ have few or no complaints; disability persists in patients who suffered concomitant displaced ipsilateral midfoot or forefoot fractures or dislocations. Neglected DLMTPJ remain symptomatic. All reduced DLIPJ are pain free.
跖趾关节（DLMTPJ）和趾间关节（DLIPJ）的创伤性脱位非常罕见。我们对31例病例以及16例已报道病例进行了回顾性分析，以明确我们对其发病机制、相关损伤的作用、推荐治疗方法及预后的认识。过伸伴轴向负荷会导致此类损伤。同侧足部骨折或脱位常同时发生，因此可能影响预后。30%的跖趾关节脱位以及几乎所有的趾间关节脱位都需要切开复位；大多数情况下，跖板妨碍了对跖趾关节脱位或趾间关节脱位进行闭合治疗。随访时，接受治疗的孤立性跖趾关节脱位患者很少或没有不适主诉；而伴有同侧中足或前足骨折或脱位的患者仍存在功能障碍。被忽视的跖趾关节脱位仍有症状。所有复位后的趾间关节均无疼痛。
