Dorsal dislocation of the first metatarsophalangeal joint with first metatarsal fracture: A case report

Abstract

Dislocation of the first metatarsophalangeal joint most commonly occurs in a dorsal direction, although dorsolateral, lateral, and plantar dislocations have been described. The current case involves a dorsal dislocation of the first metatarsophalangeal joint with intersesamoid ligament rupture (Jahss IIA). Concomitant injury to the Lisfranc complex consisted of a plantarly impacted, vertical transverse fracture at the base of the first metatarsal, distal to the first metatarsal cuneiform joint. Reduction of the first metatarsophalangeal joint dislocation was not possible until the first metatarsal base fracture was reduced. Due to the proximity of the fracture to the first metatarsal cuneiform joint, the fracture fragment was removed, and a bone block distraction first metatarsal cuneiform arthrodesis was performed. Twenty-two months following the injury the patient had returned to all activities but noted some reduction in first metatarsophalangeal joint motion.