PO 18238 - Floating metatarsal associated with comminuted calcaneocuboid joint fracture and turf toe

Introduction: The term “floating metatarsal” refers to a rare injury pattern characterized by metatarsal dislocation in both the Lisfranc and metatarsophalangeal joints. The term “turf toe” refers to the rupture of the plantar capsular-ligamentous complex of the first metatarsophalangeal joint. Objective: To report a rare case of floating metatarsal associated with turf toe and comminuted calcaneocuboid joint fracture causing a midfoot abduction deformity. Method: To report the case of a patient who suffered a motorcycle accident and progressed with this rare combination of associated injuries. Results: The patient underwent surgical cleaning, reconstruction of the plantar capsular-ligamentous injury and reduction with Kirschner wire fixation of the first metatarsal and calcaneal fracture, with a local graft for lateral column and calcaneocuboid joint lengthening. The patient progressed well in the 18-month follow-up; fracture union and good joint stability with a slight limitation in range of motion were achieved. Discussion: Floating metatarsal is an injury poorly described in the literature, and its association with turf toe is due to trauma with metatarsophalangeal hyperextension. The patient may postoperatively develop postraumatically acquired hallux rigidus and hallux valgus. Conclusion: The identification of these injuries and a good clinical evaluation are crucial for adequate treatment and the prevention of possible complications.

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Temporary Kirschner wire fixation of the first metatarsophalangeal joint before osteotomy for hallux valgus

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2021.106104 ◽

2021 ◽

pp. 106104

Author(s):

Ichiro Tonogai ◽

Koichi Sairyo

Keyword(s):

Hallux Valgus ◽

Kirschner Wire ◽

Metatarsophalangeal Joint ◽

First Metatarsophalangeal Joint ◽

Kirschner Wire Fixation ◽

Wire Fixation

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Isolated Carpal Dislocation Of The Trapezium

Serbian Journal of Experimental and Clinical Research ◽

10.1515/sjecr-2015-0008 ◽

2015 ◽

Vol 16 (1) ◽

pp. 51-54

Author(s):

Bekir Eray Kilinc ◽

Adnan Kara ◽

Mehmet Mesut Sonmez ◽

Yunus Oc ◽

Savas Camur

Keyword(s):

Open Reduction ◽

Unusual Case ◽

Kirschner Wire ◽

Stable Fixation ◽

Dorsal Approach ◽

Adequate Treatment ◽

Direct Trauma ◽

Kirschner Wire Fixation ◽

Radiological Images ◽

Wire Fixation

ABSTRACTTrapezium fractures and dislocations of the trapezium are both extremely rare injuries whether they occured with or without fractures of the surrounding bones. Specific radiological images can be difficult to help for the diagnosis. CT scan may be necessary for the diagnosis and adequate treatment. We are presenting an unusual case of volar and radial isolated trapezium dislocation concomitant second metacarpal basis fracture in which is treated by using open reduction and Kirschner wire fixation. In our case, isolated dislocation of trapezium was a result of violent and direct trauma. Different techniques have been proposed to achieve a stable fixation and the treatment outcomes. In our case, open reduction, Kirschner wire fixation and intercarpal ligament repair through dorsal approach are recommended for satisfactory outcomes in similiar cases.

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An Uncommon Presentation of Fracture-dislocation of the 4th and 5th Carpometacarpal Joints with Volar Displacement and its Management

Journal of Orthopaedic Case Reports ◽

10.13107/jocr.2021.v11.i09.2400 ◽

2021 ◽

Vol 11 (9) ◽

Author(s):

Nikhil Jawaharlal ◽

Vasanthakumar Ramsingh ◽

Vijaya Bhalaik

Keyword(s):

Kirschner Wire ◽

Fracture Dislocation ◽

Carpometacarpal Joint ◽

Carpometacarpal Joints ◽

Kirschner Wire Fixation ◽

Joint Fracture ◽

Satisfactory Outcome ◽

Uncommon Presentation ◽

Fracture Dislocations ◽

Poor Outcomes

Introduction: Carpo-metacarpal joint fracture-dislocations are rare injuries. They constitute less than 1% of all hand injuries [1]. They often go unnoticed [2]. Of these, dorsal fracture-dislocations on the ulnar side are more commonly seen [3] because of the greater stabilizing dorsal structures. Volar fracture-dislocations are very rare and difficult to diagnose for which, one should have a keen eye on. Case Report: This is a case of a 51-year-old female with a closed injury to her wrist. With clinical suspicion and appropriate radiographs fracture-dislocation of the 4th and 5th carpometacarpal joints with volar displacement was diagnosed. She underwent closed reduction and percutaneous Kirschner wire fixation, followed by 6 weeks of immobilization. At the final follow-up in 4 months, the patient was noted to have a satisfactory outcome following intense physiotherapy. Conclusion: Fourth and fifth carpometacarpal joint fracture-dislocations of the fingers are unique; their diagnosis can be challenging and often overlooked [4], which if missed can have very poor outcomes. The functional prognosis depends on the precocity of diagnosis and appropriate reduction and vigorous rehabilitation. Keywords: Carpometacarpal joint, fracture-dislocation, volar displacement, wrist injury.

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Irreducible Metatarsophalangeal Joint Dislocation of the Lesser Toes

Journal of the American Podiatric Medical Association ◽

10.7547/1030236 ◽

2013 ◽

Vol 103 (3) ◽

pp. 236-240

Author(s):

Honlok Lo ◽

Ping-Cheng Liu ◽

Po-Chih Shen ◽

Shen-Kai Chen ◽

Yuh-Min Cheng ◽

...

Keyword(s):

Kirschner Wire ◽

Metatarsophalangeal Joint ◽

Recurrent Dislocation ◽

Metatarsal Head ◽

Activity Level ◽

Rare Injury ◽

First Metatarsophalangeal Joint ◽

Joint Dislocation ◽

Plantar Plate ◽

Metatarsophalangeal Joints

Irreducible metatarsophalangeal joint dislocation of the lesser toes is a rare injury. We present a 37-year-old man who was injured in a motorcycle accident and dislocated the first to third metatarsophalangeal joints and fractured the fourth metatarsal head. The left first metatarsophalangeal joint was reduced successfully through the closed method, but multiple attempts at closed reduction under local anesthesia failed to reduce the dislocated second and third metatarsophalangeal joints. We performed a dorsal incision between the second and third metatarsals, and the metatarsal heads were found to be entrapped under the plantar plate. Dislocation reduction was performed without damage to the plantar plate, and one Kirschner wire was used to fix the fourth metatarsal head fracture. The pin was removed 8 weeks after surgery, and the patient regained normal gait and returned to work and his previous physical activity level without recurrent dislocation. (J Am Podiatr Med Assoc 103(3): 236–240, 2013)

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Experimental Intra-Articular Calcaneal Fractures: Anatomic Basis for a New Classification

Foot & Ankle ◽

10.1177/107110078901000206 ◽

1989 ◽

Vol 10 (2) ◽

pp. 81-87 ◽

Cited By ~ 63

Author(s):

James B. Carr ◽

James J. Hamilton ◽

Lance S. Bear

Keyword(s):

Treatment Plan ◽

Lateral Wall ◽

Surgical Anatomy ◽

New Classification ◽

Lateral Column ◽

Calcaneocuboid Joint ◽

Joint Fracture ◽

Anatomic Basis ◽

Calcaneus Fractures ◽

Primary Fracture

Experimental calcaneus fractures were produced by axially loading 18 specimens. Anatomic dissections were performed and documented. Two constant primary fracture lines were identified, dividing the calcaneus in the coronal and sagittal planes. A constant anterolateral fragment was identified, as were three patterns of calcaneocuboid joint fracture involvement. Based on the pathoanatomy and surgical anatomy of the calcaneus, a medial and lateral column classification is proposed. The medial column includes the superomedial fragment. The lateral column includes the calcaneocuboid joint, lateral wall and posterior facet. This concept can help identify fracture displacements and correlate them with a treatment plan.

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