0198-021 1/90/1006-0331$02.00/0 FOOT 8 ANKLE Copyright 0 1990 by the American Orthopaedic Foot and Ankle Society, Inc
Irreducible Dorsal Dislocation of the lnterphalangeal Joint of the Great Toe: Report of Two Cases Tadashi Yasuda, M.D., Keiji Fujio, M.D. and Kiyoshi Tamura, M.D. Kobe, Japan
the medial fracture fragment. When the fragment was retracted medially and the plantar plate was pushed plantarward, IP joint was reduced. The fracture fragment was fixed with two Kirschner wires (Fig. 2). The plantar plate was not repaired and the IP joint was readily dislocated by dorsiflexion. The IP joint was immobilized with a short leg cast for 6 weeks postoperatively. Three and a half years after surgery, plantarflexion was impossible although 10" of dorsiflexion was possible at the IP joint.
ABSTRACT In this paper, we report two cases of dislocation of the hallux interphalangealjoint with interpositionof the plantar plate including the sesamoid bone. These dislocations were treated with open reduction: one through lateral approach and the other through plantar approach. Plantar approach afforded repair of the plantar plate with preservation of the sesamoid bone and satisfactory result.
Irreducible dislocation of the interphalangeal (IP) joint of the great toe is rare. In the literature 33 cases have been previously reported (Table 1). We describe two cases of the dislocation of the hallux IP joint which were successfully treated with open reduction.
Case 2
A 35-year-old man jumped from a height and landed on his left great toe, which was forced into dorsiflexion. His great toe was painfully swollen and the distal phalanx was fixed in a hyperextended position. The skin over the IP joint was depressed, and a 1-cm lacerated wound was found on the plantar aspect of the IP joint. Roentgenograms showed dorsal dislocation of the IP joint with the sesamoid bone positioned over the proximal phalangeal head (Fig. 3). Manual reduction was unsuccessful; therefore open reduction was performed. A zigzag skin incision was made over the plantar aspect of the toe under digital nerve block anesthesia. The plantar plate and sesamoid bone were found displaced over the proximal phalangeal head. The sesamoid bone was locked dorsally with bilateral collateral ligaments. Thus, the sesamoid was pulled plantarward while medial collateral ligament was retracted medially and the distal phalanx was pulled distally for reduction. The plantar plate detached at the origin, the insertion site was repaired, and the operative wound was closed. The IP joint was immobilized with a Kirschner wire for 3 postoperative weeks. The postoperative course was uneventful. The patient had no complaints and was restored to almost normal function 6 months after the accident (Fig. 4). He could flex 30" and extend 0" at the IP joint.
CASEREPORTS Case 1
A 27-year-old female attempted a suicidal jump from a high building, sustaining multiple fractures. Her right hallux was swollen and the distal phalanx was hyperextended. Roentgenograms demonstrated dorsal fracture-dislocation of the IP joint with sesamoid interposition (Fig. 1). A failure of manual repositioning of the IP joint necessitated open reduction. A medial mid-lateral skin incision was adopted under digital nerve block anesthesia because the approach allowed the easiest access to the proximal phalangeal fracture. The plantar plate and sesamoid were positioned over the proximal phalangeal head. Bilateral collateral ligaments were intact and the medial collateral ligament was attached to
From the Department of Orthopaedic Surgery, Kobe City General Hospital, Kobe, Japan. Address all correspondence to Dr. Yasuda, Department of Orthopaedic Surgery, Kobe General Hospital, 4-6 Minatojimanakamachi, Chuo-ku, Kobe, 650 Japan.
331 Downloaded from fai.sagepub.com at UNIV OF MIAMI SCH OF MED on June 27, 2015
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YASUDA ET AL.
TABLE 1 Summarv of Previous Cases of Irreducible Dislocation of Hallux IP Joint
Case No.
Age (yrs)
Sex
Approach
Sesamoid bone
Type’’
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33
45 19 ? 28 19 36 16 22 35 30 40 47 19 38 14 42 21 27 21 14 54 21 35 26 25 15 15 17 17 31 ? 21 14
M M M M F M M M F M M M F M M M M M M M M M M M M M M M M F M M M
-
-
lateral lateral lateral lateral lateral lateral lateral lateral lateral lateral lateral lateral lateral lateral lateral lateral lateral dorsal dorsal dorsal dorsal dorsal dorsal plantar (zigzag) plantar (transv.) plantar (?) ? ? ? ? ? -
removed removed removed removed removed removed preSeNed preserved removed removed removed removed preserved removed removed preserved preserved removed preserved preSeNed preserved
11-1 II ? II
___
DISCUSSION
Thirty-three cases of irreducible dorsal dislocation of the IP joint of the great toe have been reported (Table 1). The cause of irreducibility is interposition of the plantar plate including the sesamoid bone. The sesamoid bone is almost completely buried in the plantar plate except in its articular surface; it articulates with the distal phalangeal base on one side and with the proximal phalangeal head on the other side. Roentgenographic identification of the sesamoid depends largely on the size of the bone and the quality of the roentgenograms. The sesamoid bone was macroscopically found in 95.5% of 144 feet of 73 Japanese adult cadavers.” This implies that most adults have a sesamoid at the IP joint of the great toe. However, the sesamoid cannot always be demonstrated on roentgenograms. The mechanism of irreducible dorsal dislocation of the hallux IP joint could be considered as followsi2: detachment of the plantar plate occurs first at the origin
removed preSeNed removed
removed removed removed preserved preserved
? 11-1 II 11-1 11-1 II II II II 11-1 11-1 I 11-1 11-1 II 11-1 II II II I I II 11-1 II 11-1 ? I ? 11-1
Reference Number 11 21 14 15 6 20 20 20 4 4 9 9 9 8 8 19 2 2
2 1 16 17 12 12 21 5 2 21 13 22 7 18 3
to the proximal phalangeal bone and next at the insertion site into the distal phalanx with forceful hyperextension of the IP joint. The detached plantar plate is unstabilized, displaced, and trapped into the IP joint. Manual reduction seems to be difficult because the detached plantar plate cannot be repositioned without direct force applied to the plate. In our cases, IP joint dislocation was caused probably by the above-mentioned mechanism. In case 2, furthermore, locking of the sesamoid with the intact collateral ligaments made manual reduction difficult. Irreducible dorsal dislocations of the IP joint of the great toe are divided into two types according to Miki et al.’s classification.’2 Type I is considered as dislocation or subluxation with the plantar plate displaced into the IP joint space. Roentgenograms show the IP joint space is widened and the sesamoid is trapped within the IP joint space, but the distal phalanx is not hyperextended. In type II dislocations, the plantar plate including the sesamoid is displaced dorsally over the proximal phalangeal head. Roentgenograms demonstrate the IP joint is completely dorsally dislocated and
Downloaded from fai.sagepub.com at UNIV OF MIAMI SCH OF MED on June 27, 2015
Foot & Ankle/Vol. 10, No. GIJune, 1990
333
Fig. 1. A, An AP roentgenogram of the hallux shows fracture of the proximal phalangeal head. B, On a lateral roentgenogram, the IP joint is dorsally dislocated. The sesamoid bone is displaced over the proximal phalangeal head.
the sesamoid is located over the proximal phalangeal head. Our cases are type II dislocations. The two types may be interchangeable through repeated manipulations. It should be borne in mind that such a dislocation can be mistaken to have been reduced, because hyperextension deformity is corrected when a type II dislocation is changed to type I by manipulation, as previously reported (Table 1). In the literature, only two patients were manually reduced,’ 1.2’ and the other patients were operatively reduced. In operative cases, lateral approach was most commonly used, as in our case 1. The dorsal approach was next most commonly used (Table 1). In case 1 , concomitance of fracture of the proximal phalangeal head largely contributed to the successful reduction, with preservation of the plantar plate including the sesamoid bone through lateral approach. However, the plantar plate could not be repaired through lateral approach, and the IP joint was readily dislocated dorsally
at surgery. There was no postoperative complaint, but there was restricted motion at the IP joint. In case 2, a plantar zigzag incision proved to be very useful and therefore is recommended; it secures enough exposure of the joint to closely observe dislocation and interposition of the plantar plate and successful reduction. In addition, plantar approach made it possible to repair detachment of the plantar plate at the origin and the insertion site and to preserve the sesamoid bone. Plantar approach afforded a satisfactory result. In spite of difficulties in manipulating the dislocated sesamoid plantarward reported in previous cases (Table l ) , the sesamoid bone should be kept in situ because it articulates with the proximal phalangeal head and the distal phalangeal base. Repair of the plantar plate is also necessary for the prevention of hyperextension of the IP joint. A postoperativescar due to plantar skin incision is unlikely to cause pain unless the incision extends to the contact area of the distal phalanx upon weightbearing.
Downloaded from fai.sagepub.com at UNIV OF MIAMI SCH OF MED on June 27, 2015
Fig. 2.
Fracture fragment was fixed with two Kirschner wires after open reduction of the IP joint through lateral approach.
Fig. 3. A, An AP roentgenogram demonstrates overlapping of the proximal phal-
angeal head and the distal phalangeal base. 8, lateral roentgenogram reveals the dorsal dislocationof the IP joint with the sesamoid overriding the proximal phalangeal head.
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Fig. 4.
335
A, B, X-ray films 6 months postoperatively. C, The patient has no complaints due to the scar of the plantar skin incision.
REFERENCES
1. Eibel, P.: Dislocation of the interphalangeal joint of the big toe with interposition of a sesamoid bone. J. Bone Joint Surg., 36A 880-882,1954. 2. Edno, S., Hoshi, S., and Tsuchiya, M.: Irreducible dislocation of the interphalangeal joint of the great toe: report of four cases. Seikeigeka 38:2023-2027, 1987 (in Japanese). 3. Hayashi M., et al.: A case of pseudoreposition of interphalangeal dislocation of a big toe with interposition of sesamoid bone. Tokyo Women's Medical College Journal 45: 566, 1975 (in Japanese). 4. Hojyo, H., Nagata, K., Narahara, T., et al.: Two cases of irreducible dislocation of the interphalangealjoint of the great toe with interposition of sesamoid bone. Seikeigeka 3 4 820-824, 1983 (in Japanese). 5. Ikeda, K., Takeda, K., Shigematsu, S., et el.: A case of dorsal dislocation of the interphalangeal joint of the great toe with interposition of the sesamoid. Ashinogeka Kenkyukaishi 6: 7477, 1985 (in Japanese). 6. Ishiraki, H., and Matsumoto, T.: Dislocation of IP joint of a big toe with interposition of a sesamoid. A case report. Hokkaido Seisaishi 1 8 116, 1973 (in Japanese). 7. Laczay, A., and Csapo, K.: lnterphalangeale Luxation der Grosszehe mit Interposition eines Sesambeines. Fortschr. Geb. Roentgenstr. Nuklear med. Erganzungsband 116 571-572, 1972. 8. Machida, H., Kusumoto, T., Ogami, S., et el.: Irreducible dislocation of the interphalangeal joint of the great toe with the interposition of the sesamoid bone: report of two cases. Gunma lgaku 39:34-37, 1983 (in Japanese). 9. Masaki, T., Shinai, Y., Ishihara, M., et al.: Unsuccessful closed
10.
11. 12.
13. 14. 15.
16.
17.
18.
19.
reduction of the dislocation of the great toe disturbed by the sesamoid interposition. Report of three cases. Kantou Seikaishi 13:364-366, 1982 (in Japanese). Masaki, T.: An anatomical study of the interphalangealsesamoid bone of the hallux. J. Jpn. Orthop. Assoc. 5 8 417-419, 1984 (in Japanese). Matsumoto, K.: lnterphalangeal dislocation. A report of two further cases. J. Jpn. Orthop. Assoc. 5: 639,1942 (in Japanese). Miki, T., Yamamuro, T., and Kitoi, 1.:An irreducible dislocation of the great toe. Report of two cases and review of the literature. Clin. Orthop. 230 200-206, 1988. Momota, M.: Transposition of the sesamoid. A case report. Saigaiigaku 5: 168-1 69, 1962 (in Japanese). Muller, OM.: Dislocation of sesamoid of hallux. Lancet 1: 789, 1944. Murakami, Y., and Tokuyasu, Y.: A dislocation of IP joint of a big toe where closed reduction was impossible because of the interposed sesamoid bone. A case report. Seikeigeka 2 2 751753, 1971 (in Japanese). Nelson, T.L., and Uggen, W.: Irreducible dorsal dislocation of the interphalangealjoint of the great toe. Clin. Orthop. 157: 110112, 1981. Nomura, S., Kojima, T., and Miroguchi, T.: A dislocation of IP joint of a big toe where closed reductionwas impossible because of the interposed sesamoid (author's translation in Japanese). Presented at the 64th Academic Meeting. West Japan Orthopaedic and Traumatic Surgery, Oct. 23.1982, Nagasaki, Japan. Ogata, E., and Honda, K.: Dislocation of IP joint of a big toe which required open reduction. A case report. Kanagawa Igakukaishi 1: 184, 1973 (in Japanese). Ohi, K., Asai, H., Kin, Y., et al.: One case of dorsal dislocation of the interphalangealjoint of the great toe with interposition of
Downloaded from fai.sagepub.com at UNIV OF MIAMI SCH OF MED on June 27, 2015
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sesarnoid bone. Rinsho Seikei Geka 20: 899-902, 1985 (in Japanese). 20. Takura, H., et al.: Unsuccessful closed reduction of the dislocation of the great toe disturbed by the sesarnoid bone interposition. Report of three cases. Kantou Seisaishi 4: 154-1 57, 1973 (in Japanese).
21. Tsukahara, T., Horie, M., Sekiguchi, W., et at.: Three cases of dorsal dislocation of interphalangeal joint of the big toe. Seikeigeka 40: 925-929,1989 (in Japanese). 22. Zimmer, E.A.: Grenzen des Norrnalen und Anfanges des Pathologischen in Roentgenbild des Skelets, Georg Thieme, Stuttgart, 1967.
Downloaded from fai.sagepub.com at UNIV OF MIAMI SCH OF MED on June 27, 2015
Irreducible Dorsal Dislocation of the lnterphalangeal Joint of the Great Toe: Report of Two Cases Tadashi Yasuda, M.D., Keiji Fujio, M.D. and Kiyoshi Tamura, M.D. Kobe, Japan
the medial fracture fragment. When the fragment was retracted medially and the plantar plate was pushed plantarward, IP joint was reduced. The fracture fragment was fixed with two Kirschner wires (Fig. 2). The plantar plate was not repaired and the IP joint was readily dislocated by dorsiflexion. The IP joint was immobilized with a short leg cast for 6 weeks postoperatively. Three and a half years after surgery, plantarflexion was impossible although 10" of dorsiflexion was possible at the IP joint.
ABSTRACT In this paper, we report two cases of dislocation of the hallux interphalangealjoint with interpositionof the plantar plate including the sesamoid bone. These dislocations were treated with open reduction: one through lateral approach and the other through plantar approach. Plantar approach afforded repair of the plantar plate with preservation of the sesamoid bone and satisfactory result.
Irreducible dislocation of the interphalangeal (IP) joint of the great toe is rare. In the literature 33 cases have been previously reported (Table 1). We describe two cases of the dislocation of the hallux IP joint which were successfully treated with open reduction.
Case 2
A 35-year-old man jumped from a height and landed on his left great toe, which was forced into dorsiflexion. His great toe was painfully swollen and the distal phalanx was fixed in a hyperextended position. The skin over the IP joint was depressed, and a 1-cm lacerated wound was found on the plantar aspect of the IP joint. Roentgenograms showed dorsal dislocation of the IP joint with the sesamoid bone positioned over the proximal phalangeal head (Fig. 3). Manual reduction was unsuccessful; therefore open reduction was performed. A zigzag skin incision was made over the plantar aspect of the toe under digital nerve block anesthesia. The plantar plate and sesamoid bone were found displaced over the proximal phalangeal head. The sesamoid bone was locked dorsally with bilateral collateral ligaments. Thus, the sesamoid was pulled plantarward while medial collateral ligament was retracted medially and the distal phalanx was pulled distally for reduction. The plantar plate detached at the origin, the insertion site was repaired, and the operative wound was closed. The IP joint was immobilized with a Kirschner wire for 3 postoperative weeks. The postoperative course was uneventful. The patient had no complaints and was restored to almost normal function 6 months after the accident (Fig. 4). He could flex 30" and extend 0" at the IP joint.
CASEREPORTS Case 1
A 27-year-old female attempted a suicidal jump from a high building, sustaining multiple fractures. Her right hallux was swollen and the distal phalanx was hyperextended. Roentgenograms demonstrated dorsal fracture-dislocation of the IP joint with sesamoid interposition (Fig. 1). A failure of manual repositioning of the IP joint necessitated open reduction. A medial mid-lateral skin incision was adopted under digital nerve block anesthesia because the approach allowed the easiest access to the proximal phalangeal fracture. The plantar plate and sesamoid were positioned over the proximal phalangeal head. Bilateral collateral ligaments were intact and the medial collateral ligament was attached to
From the Department of Orthopaedic Surgery, Kobe City General Hospital, Kobe, Japan. Address all correspondence to Dr. Yasuda, Department of Orthopaedic Surgery, Kobe General Hospital, 4-6 Minatojimanakamachi, Chuo-ku, Kobe, 650 Japan.
331 Downloaded from fai.sagepub.com at UNIV OF MIAMI SCH OF MED on June 27, 2015
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Foot & Ankle/Vol. 10, No. GIJune, 1990
YASUDA ET AL.
TABLE 1 Summarv of Previous Cases of Irreducible Dislocation of Hallux IP Joint
Case No.
Age (yrs)
Sex
Approach
Sesamoid bone
Type’’
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33
45 19 ? 28 19 36 16 22 35 30 40 47 19 38 14 42 21 27 21 14 54 21 35 26 25 15 15 17 17 31 ? 21 14
M M M M F M M M F M M M F M M M M M M M M M M M M M M M M F M M M
-
-
lateral lateral lateral lateral lateral lateral lateral lateral lateral lateral lateral lateral lateral lateral lateral lateral lateral dorsal dorsal dorsal dorsal dorsal dorsal plantar (zigzag) plantar (transv.) plantar (?) ? ? ? ? ? -
removed removed removed removed removed removed preSeNed preserved removed removed removed removed preserved removed removed preserved preserved removed preserved preSeNed preserved
11-1 II ? II
___
DISCUSSION
Thirty-three cases of irreducible dorsal dislocation of the IP joint of the great toe have been reported (Table 1). The cause of irreducibility is interposition of the plantar plate including the sesamoid bone. The sesamoid bone is almost completely buried in the plantar plate except in its articular surface; it articulates with the distal phalangeal base on one side and with the proximal phalangeal head on the other side. Roentgenographic identification of the sesamoid depends largely on the size of the bone and the quality of the roentgenograms. The sesamoid bone was macroscopically found in 95.5% of 144 feet of 73 Japanese adult cadavers.” This implies that most adults have a sesamoid at the IP joint of the great toe. However, the sesamoid cannot always be demonstrated on roentgenograms. The mechanism of irreducible dorsal dislocation of the hallux IP joint could be considered as followsi2: detachment of the plantar plate occurs first at the origin
removed preSeNed removed
removed removed removed preserved preserved
? 11-1 II 11-1 11-1 II II II II 11-1 11-1 I 11-1 11-1 II 11-1 II II II I I II 11-1 II 11-1 ? I ? 11-1
Reference Number 11 21 14 15 6 20 20 20 4 4 9 9 9 8 8 19 2 2
2 1 16 17 12 12 21 5 2 21 13 22 7 18 3
to the proximal phalangeal bone and next at the insertion site into the distal phalanx with forceful hyperextension of the IP joint. The detached plantar plate is unstabilized, displaced, and trapped into the IP joint. Manual reduction seems to be difficult because the detached plantar plate cannot be repositioned without direct force applied to the plate. In our cases, IP joint dislocation was caused probably by the above-mentioned mechanism. In case 2, furthermore, locking of the sesamoid with the intact collateral ligaments made manual reduction difficult. Irreducible dorsal dislocations of the IP joint of the great toe are divided into two types according to Miki et al.’s classification.’2 Type I is considered as dislocation or subluxation with the plantar plate displaced into the IP joint space. Roentgenograms show the IP joint space is widened and the sesamoid is trapped within the IP joint space, but the distal phalanx is not hyperextended. In type II dislocations, the plantar plate including the sesamoid is displaced dorsally over the proximal phalangeal head. Roentgenograms demonstrate the IP joint is completely dorsally dislocated and
Downloaded from fai.sagepub.com at UNIV OF MIAMI SCH OF MED on June 27, 2015
Foot & Ankle/Vol. 10, No. GIJune, 1990
333
Fig. 1. A, An AP roentgenogram of the hallux shows fracture of the proximal phalangeal head. B, On a lateral roentgenogram, the IP joint is dorsally dislocated. The sesamoid bone is displaced over the proximal phalangeal head.
the sesamoid is located over the proximal phalangeal head. Our cases are type II dislocations. The two types may be interchangeable through repeated manipulations. It should be borne in mind that such a dislocation can be mistaken to have been reduced, because hyperextension deformity is corrected when a type II dislocation is changed to type I by manipulation, as previously reported (Table 1). In the literature, only two patients were manually reduced,’ 1.2’ and the other patients were operatively reduced. In operative cases, lateral approach was most commonly used, as in our case 1. The dorsal approach was next most commonly used (Table 1). In case 1 , concomitance of fracture of the proximal phalangeal head largely contributed to the successful reduction, with preservation of the plantar plate including the sesamoid bone through lateral approach. However, the plantar plate could not be repaired through lateral approach, and the IP joint was readily dislocated dorsally
at surgery. There was no postoperative complaint, but there was restricted motion at the IP joint. In case 2, a plantar zigzag incision proved to be very useful and therefore is recommended; it secures enough exposure of the joint to closely observe dislocation and interposition of the plantar plate and successful reduction. In addition, plantar approach made it possible to repair detachment of the plantar plate at the origin and the insertion site and to preserve the sesamoid bone. Plantar approach afforded a satisfactory result. In spite of difficulties in manipulating the dislocated sesamoid plantarward reported in previous cases (Table l ) , the sesamoid bone should be kept in situ because it articulates with the proximal phalangeal head and the distal phalangeal base. Repair of the plantar plate is also necessary for the prevention of hyperextension of the IP joint. A postoperativescar due to plantar skin incision is unlikely to cause pain unless the incision extends to the contact area of the distal phalanx upon weightbearing.
Downloaded from fai.sagepub.com at UNIV OF MIAMI SCH OF MED on June 27, 2015
Fig. 2.
Fracture fragment was fixed with two Kirschner wires after open reduction of the IP joint through lateral approach.
Fig. 3. A, An AP roentgenogram demonstrates overlapping of the proximal phal-
angeal head and the distal phalangeal base. 8, lateral roentgenogram reveals the dorsal dislocationof the IP joint with the sesamoid overriding the proximal phalangeal head.
Downloaded from fai.sagepub.com at UNIV OF MIAMI SCH OF MED on June 27, 2015
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Fig. 4.
335
A, B, X-ray films 6 months postoperatively. C, The patient has no complaints due to the scar of the plantar skin incision.
REFERENCES
1. Eibel, P.: Dislocation of the interphalangeal joint of the big toe with interposition of a sesamoid bone. J. Bone Joint Surg., 36A 880-882,1954. 2. Edno, S., Hoshi, S., and Tsuchiya, M.: Irreducible dislocation of the interphalangeal joint of the great toe: report of four cases. Seikeigeka 38:2023-2027, 1987 (in Japanese). 3. Hayashi M., et al.: A case of pseudoreposition of interphalangeal dislocation of a big toe with interposition of sesamoid bone. Tokyo Women's Medical College Journal 45: 566, 1975 (in Japanese). 4. Hojyo, H., Nagata, K., Narahara, T., et al.: Two cases of irreducible dislocation of the interphalangealjoint of the great toe with interposition of sesamoid bone. Seikeigeka 3 4 820-824, 1983 (in Japanese). 5. Ikeda, K., Takeda, K., Shigematsu, S., et el.: A case of dorsal dislocation of the interphalangeal joint of the great toe with interposition of the sesamoid. Ashinogeka Kenkyukaishi 6: 7477, 1985 (in Japanese). 6. Ishiraki, H., and Matsumoto, T.: Dislocation of IP joint of a big toe with interposition of a sesamoid. A case report. Hokkaido Seisaishi 1 8 116, 1973 (in Japanese). 7. Laczay, A., and Csapo, K.: lnterphalangeale Luxation der Grosszehe mit Interposition eines Sesambeines. Fortschr. Geb. Roentgenstr. Nuklear med. Erganzungsband 116 571-572, 1972. 8. Machida, H., Kusumoto, T., Ogami, S., et el.: Irreducible dislocation of the interphalangeal joint of the great toe with the interposition of the sesamoid bone: report of two cases. Gunma lgaku 39:34-37, 1983 (in Japanese). 9. Masaki, T., Shinai, Y., Ishihara, M., et al.: Unsuccessful closed
10.
11. 12.
13. 14. 15.
16.
17.
18.
19.
reduction of the dislocation of the great toe disturbed by the sesamoid interposition. Report of three cases. Kantou Seikaishi 13:364-366, 1982 (in Japanese). Masaki, T.: An anatomical study of the interphalangealsesamoid bone of the hallux. J. Jpn. Orthop. Assoc. 5 8 417-419, 1984 (in Japanese). Matsumoto, K.: lnterphalangeal dislocation. A report of two further cases. J. Jpn. Orthop. Assoc. 5: 639,1942 (in Japanese). Miki, T., Yamamuro, T., and Kitoi, 1.:An irreducible dislocation of the great toe. Report of two cases and review of the literature. Clin. Orthop. 230 200-206, 1988. Momota, M.: Transposition of the sesamoid. A case report. Saigaiigaku 5: 168-1 69, 1962 (in Japanese). Muller, OM.: Dislocation of sesamoid of hallux. Lancet 1: 789, 1944. Murakami, Y., and Tokuyasu, Y.: A dislocation of IP joint of a big toe where closed reduction was impossible because of the interposed sesamoid bone. A case report. Seikeigeka 2 2 751753, 1971 (in Japanese). Nelson, T.L., and Uggen, W.: Irreducible dorsal dislocation of the interphalangealjoint of the great toe. Clin. Orthop. 157: 110112, 1981. Nomura, S., Kojima, T., and Miroguchi, T.: A dislocation of IP joint of a big toe where closed reductionwas impossible because of the interposed sesamoid (author's translation in Japanese). Presented at the 64th Academic Meeting. West Japan Orthopaedic and Traumatic Surgery, Oct. 23.1982, Nagasaki, Japan. Ogata, E., and Honda, K.: Dislocation of IP joint of a big toe which required open reduction. A case report. Kanagawa Igakukaishi 1: 184, 1973 (in Japanese). Ohi, K., Asai, H., Kin, Y., et al.: One case of dorsal dislocation of the interphalangealjoint of the great toe with interposition of
Downloaded from fai.sagepub.com at UNIV OF MIAMI SCH OF MED on June 27, 2015
336
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Foot & Ankle/Vol. 10, No. GIJune, 1990
sesarnoid bone. Rinsho Seikei Geka 20: 899-902, 1985 (in Japanese). 20. Takura, H., et al.: Unsuccessful closed reduction of the dislocation of the great toe disturbed by the sesarnoid bone interposition. Report of three cases. Kantou Seisaishi 4: 154-1 57, 1973 (in Japanese).
21. Tsukahara, T., Horie, M., Sekiguchi, W., et at.: Three cases of dorsal dislocation of interphalangeal joint of the big toe. Seikeigeka 40: 925-929,1989 (in Japanese). 22. Zimmer, E.A.: Grenzen des Norrnalen und Anfanges des Pathologischen in Roentgenbild des Skelets, Georg Thieme, Stuttgart, 1967.
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