MTP joint dislocation

MTP joint dislocation is a dislocation of the proximal phalanx from the articulation with the metatarsal head.

• Dislocation of the MTP joint may occur as an isolated injury, but more commonly, it occurs in conjunction with other injuries
• Typically the proximal phalanx dislocates dorsally
• Because of the risk of neurovascular compromise, the reduction should be performed as quickly as possible
• The toe will be shortened and there will be a disruption of the normal cascade
• The skin is usually not compromised with these injuries
• Soft tissue dimpling may signify entrapped soft tissue, which may prevent a closed reduction necessitating an open reduction
• The preexisting deformity may make diagnosis challenging without x-rays

This injury is the result of a dorsiflexing force. The sling that connects the joint’s dorsal hood with the plantar plate ruptures, allowing the proximal phalanx to dislocate dorsally.

Or, the plantar plate can fail in its plantar attachment, resulting in the proximal phalanx dislocating dorsally.

AP and lateral oblique views are sufficient for diagnosis and treatment.

Lateral view of the same case