Irreducible Dislocation of Interphalangeal Joint of The Great Toe Secondary to An Incarcerated Volar Plate Along with Sesamoid Bone - A Rare Case Report

Rajula Iswarya; Ch Pratyush; V Madhukar; Joseph Kartheek

Volume : VIII, Issue : III, March - 2019

Irreducible Dislocation of Interphalangeal Joint of The Great Toe Secondary to An Incarcerated Volar Plate Along with Sesamoid Bone - A Rare Case Report

Rajula Iswarya, Ch Pratyush, V Madhukar, Joseph Kartheek

Abstract :

Irreducible dorsal dislocation of the interphalangeal (IP) joint of the great toe due to incarcerated sesamoid and volar plate is rare with only few cases reported in literature. We report a case of a 20–year–old gentleman who presented to the emergency room with an open injury exposing the IP joint which is irreducible. The mechanism of injury might be due to combined axial and hyper dorsiflexion force, when the patient foot had an impact to a vehicle. IP joint was irreducible despite multiple attempts of closed reduction. On radiological evaluation incarceration of the sesamoid along with volar plate was identified. Intact collateral ligaments and displaced sesamoid bone along with volar plate is the main obstruction for reduction of IP joint and was a block to manipulation and reduction in the emergency room. An open surgical exploration with resection of the incarcerated sesamoid along with volar plate was done, followed by Kirschner–wire fixation of the IP joint. The operative course was uneventful. At 6 months after surgery, the patient could walk, run, and return to sports.