Neglected dorsolateral dislocation of the first metatarsophalangeal joint: A case report

Al-Mohrej, Omar A.; AlOmair, Abdulrahman A.; Alfehaid, Yara A.; Alsumali, Abubaker A.; Al-Kenani, Nader S.

The mechanism of dorsal dislocation injury is hyperextension of forefoot [15] . The relationship of bony and soft tissue structures contributes to the stability of the joint. The first MTP joint is different from the articulations of the lesser toes since it contains the two sesamoids which are linked to the proximal phalanx and they are also placed in the thick fibrous plantar plate [7] . A thick intersesamoidal ligament acts as an attachment agent for each other to work in tandem. In addition, the two sesamoids have been observed to move in connection with the phalanx. The plantar plate or first metatarsophalangeal joint capsule is more or less weaker at its metatarsal insertion [3] . Furthermore, the lateral and medial sesamoids of the first metatarsophalangeal joint exist inside the identical tendons of flexor hallucis brevis going into the lateral and medial aspects of the big toe proximal phalanx, with adductor hallucis and abductor. As such, this can explain why the sesamoid complex is always with the proximal phalanx and not following the metatarsal head in the action of traumatic displacements process.