Bipolar Dislocation of the Proximal Phalanx of Toe: A Rare Injury

Abstract

We report a very rare case of bipolar fracture with dislocation of the proximal phalanx or floating proximal phalanx of the toe. The literature has shown that closed reduction gives a lesser chance of success considering the inherent anatomy of the foot. We report a case of a 40-year-old male with an open injury to his right foot involving bipolar dislocation of the proximal phalanx of the third toe with extensor digitorum longus tendon injury and fracture of the neck of the fourth proximal phalanx of the right foot. With the realization that open reduction and Kirschner wire fixation are good options in patients with such a presentation, a prompt and accurate diagnosis with a treatment plan was made, which lead to clinical success.

Keywords: floating proximal phalanx of toe.

Figure 1. Clinical picture of the right foot following trauma.

Figure 2. Plain radiographs of the right foot in anteroposterior and oblique views showing bipolar dislocation of the proximal phalanx of the third toe and neck of the fourth proximal phalanx fracture.

Figure 3. Failed closed reduction radiographs.

Figure 4. Post-reduction following open reduction with Kirschner wire fixation.