Irreducible dislocation of the interphalangeal joint of the great toe in a collegiate football player due to sesamoid bone interposition- a case report and literature review

摘要

The dorsal dislocation of the interphalangeal joint of great toe with intra-articular displacement of a sesamoid bone is rare injury. Recommended treatment is a trial of closed reduction and open reduction in failure of closed reduction. We report this unusual injury in a collegiate football player. Closed reduction failed and open reduction through dorsal approach was performed to reduce the dislocation. Patient returned to competitive sports without any functional disability. Introduction Intra-articular sesamoid dislocation is a rare injury and may lead to difficulty in reduction and diagnosis [1]. The interphalangeal sesamoid of the phalanx is only present in approximately 13 per cent of the population [2, 3]. The increasing number of competitive and recreational athletes has resulted in more sports-related foot injuries [4]. We report a case of irreducible dislocation in a sportsman. Case report A 20-year-old male presented to the Accident & Emergency department with painful swelling of the right big toe while playing football. The patient’s foot struck against the goal- post during the match. Examination revealed a tender and swollen right hallux with distal phalanx in slight extension. Passive movements of the interphalangeal joint were painful. There was no wound on the hallux. Radiographs revealed widening of interphalangeal joint space with intra-articular entrapment of sesamoid bone. The distal phalanx was subluxated dorsally and medially (Fig. 1).