Abstract
A 53-years-old man injured his left foot while walking, and the great toe was forced into dorsiflexion and varus. Radiographs showed dorsal-medial dislocation of the great toe distal phalanx. Several attempts at closed reduction were unsuccessful. An open reduction was therefore carried out via the dorsal approach. The capsule was ruptured and dislocation of the interphalangeal (IP) joint was observed. The sesamoid bone was found to be displaced over the proximal phalangeal head. A curved spatula was inserted between the proximal phalangeal head and the sesamoid. The flexed IP joint allowed reduction. After the reduction, the joint was unstable in the varus direction, and therefore lateral collateral ligament injury was suspected. A Kirschner wire was placed longitudinally across the IP joint for three weeks post operatively to help hold the reduction. At six weeks of follow-up radiography showed no varus instability. Three months after surgery, the patient has no complaints with almost normal function.
