Surgical Techniques   |    
Dislocation of the Interphalangeal Joint of the Great Toe: Is Percutaneous Reduction of an Incarcerated Sesamoid an Option?Surgical Technique
Colin Yi-Loong Woon, MBBS, MRCS(Edin), MMed(Surg), MMed(Ortho)1
1 Department of Orthopaedic Surgery, Singapore General Hospital, 169608 Singapore. E-mail address: wolv23@gmail.com
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DISCLOSURE: The author did not receive any outside funding or grants in support of his research for or preparation of this work. Neither he nor a member of his immediate family received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Investigation performed at the Department of Orthopaedic Surgery, Singapore General Hospital, Singapore
The original case report in which the surgical technique was presented was published in JBJS Vol. 92-A, pp. 1257-60, May 2010

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2011 Mar 16;93(Supplement 1):109-112. doi: 10.2106/JBJS.J.01062
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An eighteen-year-old male student fell from a height onto the left foot, hyperextending the great toe. There was swelling and tenderness with hyperextension of the distal phalanx and dimpling of the skin over the interphalangeal joint. Radiographs revealed a Miki1 type-II dislocation of the interphalangeal joint (Fig. 1-A) and an entrapped sesamoid.Closed reduction, done with the patient under general anesthesia and with fluoroscopic guidance, was unsuccessful (Fig. 1-B), and percutaneous reduction of the incarcerated sesamoid was performed (Fig. 1-C). In view of perceived joint laxity, the joint was opened dorsally and the interphalangeal joint space was examined to confirm that no residual tissue was interposed between the phalanges. The incision was closed, and the joint was immobilized with a 1.25-mm Kirschner wire, which was removed at four weeks.
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