Chronic irreducible dislocation of the proximal interphalangeal joint of the fifth toe: a case report

Acute Isolated Irreducible Proximal Interphalangeal Joint Dislocation of the Fifth Toe in a Toddler: A Case Report

A male child aged three years and three months presented after stubbing his right fifth toe. Imaging revealed a dorsolateral dislocation of the proximal interphalangeal joint (PIPJ). After failed attempts at closed reduction, open reduction and internal fixation was pursued. At the one-year follow-up, the patient was found to be doing well clinically and radiographically. These types of injuries require a high degree of clinical suspicion to obtain the proper imaging. The interposition of adjacent soft tissues can render these injuries irreducible. When irreducible, open reduction and pin fixation may be appropriate after an adequate trial of closed reduction under anesthesia. Concomitant ligamentous injuries, avulsion injuries, and fracture-dislocations often accompany these injuries; however, they can also occur in isolation.

Traumatic boutonniere deformity of the second toe caused by sumo wrestling: A case report

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A case of boutonniere deformity of the second toe caused by sumo wrestling.

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Forced passive flexion exerted on an actively extended PIP joint is the likely cause.

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Surgical repair of the extensor mechanism and temporary pinning were effective.

Introduction

Traumatic boutonniere deformities of the fingers are well documented unlike those of the lesser toes. With few existing reports on boutonniere deformities of the lesser toes, the related pathology and treatment guidelines remain unclear.

Presentation of case

We present a case of traumatic boutonniere deformity of the second toe caused by sumo wrestling in a 23-year-old man. A flexion deformity of the proximal interphalangeal joint and hyperextension of the distal interphalangeal joint of the right second toe were observed, including a torn central slip and plantarly displaced lateral bands during surgery. Surgical repair of the extensor mechanism and temporary pinning led to good clinical results.

Discussion

Acute traumatic boutonniere deformity of the interphalangeal joint of the lesser toe is very rare. The mechanism of boutonniere deformity in this case is thought to be due to forced passive flexion exerted on an actively extended PIP joint, which is similar to that seen in fingers.

Conclusion

We describe the pathophysiology of a case of boutonniere deformity of the lesser toe and suggest the effectiveness of surgical treatment.

Irreducible Dislocation of the Proximal Interphalangeal Joint of the Second Toe in a Six-Year-Old Child: A Case Report

CASE

Closed reduction was unsuccessful in a 6-year-old girl with a dislocated proximal interphalangeal joint of the second toe. Surgical exploration revealed soft-tissue entrapment by a ruptured medial collateral ligament. After the entrapment was cleared, the joint was reduced but remained unstable. The ligament was repaired with an all-suture mini-anchor to restore stability. The patient had a good recovery, and normal toe function had been restored by 3 months.

CONCLUSION

This rare case demonstrates the safety of the use of all-suture mini-anchors in treating similar injuries in children because they leave a minimal footprint and a minimal amount of foreign material.