×
Home Current Archive Editorial board
News Contact
Review paper

Post-traumatic instability of the first metatarsophalangeal joint: a novel surgical technique of capsular reconstruction in a young kickboxer

By
Gianni Caizzi Orcid logo ,
Gianni Caizzi
Contact Gianni Caizzi

Department of Basic Medical Science, Neuroscience and Sensory Organs, Azienda Ospedaliero Universitaria Consorziale Policlinico, Bari, Italy

Michele Coviello ,
Michele Coviello
Contact Michele Coviello

Department of Basic Medical Science, Neuroscience and Sensory Organs, Azienda Ospedaliero Universitaria Consorziale Policlinico, Bari, Italy

Andrea Franchini ,
Andrea Franchini

Department of Basic Medical Science, Neuroscience and Sensory Organs, Azienda Ospedaliero Universitaria Consorziale Policlinico, Bari, Italy

Flavia Riefoli ,
Flavia Riefoli

Department of Basic Medical Science, Neuroscience and Sensory Organs, Azienda Ospedaliero Universitaria Consorziale Policlinico, Bari, Italy

Florianna Palmiotto ,
Florianna Palmiotto

Department of Basic Medical Science, Neuroscience and Sensory Organs, Azienda Ospedaliero Universitaria Consorziale Policlinico, Bari, Italy

Biagio Moretti
Biagio Moretti

Department of Basic Medical Science, Neuroscience and Sensory Organs, Azienda Ospedaliero Universitaria Consorziale Policlinico, Bari, Italy

Abstract

Aim
To report a novel surgical technique of capsular reconstruction of post-traumatic instability of the first metatarsophalangeal joint (MTPJ).
Methods
The clinical case is related to a 24-year-old male athlete whose clinical symptoms began with pain and spontaneous dislocation of the left first MTPJ during a kickboxing fight. He received conservative treatment (cryotherapy and rest) at first. Afterwards, he referred persistent hallux instability associated with moderate pain, despite normal anatomic alignment with no evidence of first ray deformity. Plain traditional x-rays of the left foot, magnetic resonance imaging (MRI), static and dynamic ultrasonography (US) and clinical tests were performed in order to diagnose capsular ligamentous structure lesions. Results
The plain x-rays showed hallux abductus angle of 3°. The MRI and US demonstrated a rupture of the lateral capsular ligamentous structures and detachment of the abductor tendon. The pull out medium-lateral of the capsule with the abductor suture was performed as a treatment for dynamic hallux varus deformity. At six-month follow up, the patient walked without lameness with complete active and passive range of motion and with a stable first MTPJ. Conclusion
The patient presented with the post traumatic instability of the first metatarsophalangeal joint treated with a novel surgical technique of capsular reconstruction. The patient returned to the full weight-bearing in only 2 months of rehab. To the best of our knowledge, the surgical correction proposed has not been previously described.

References

1.
Labovitz J, Kaczander B. Traumatic hallux varus repair utilizing a soft-tissue anchor: a case report. J Foot Ankle Surg. 2000. p. 120–3.
2.
Loosemore M, Lightfoot J, Palmer-Green D, Gatt I, Bilzon J, Beardsley C. Boxing injury epidemiology in the Great Britain team: a 5-year surveillance study of medically diagnosed injury incidence and outcome. Br J Sports Med. 2015. p. 1100–7.
3.
Rinonapoli G, Graziani M, Ceccarini P, Razzano C, Manfreda F, Caraffa A. Epidemiology of injuries connected with dance: a critical review on epidemiology. Med Glas (Zenica). 2020. p. 256–64.
4.
Mullis D, Miller W. A disabling sports injury of the great toe. Foot Ankle. 1980. p. 22–5.
5.
Bijur P, Silver W, Gallagher E. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med. 2001. p. 1153–7.
6.
Hays R, Sherbourne C, Mazel R. The RAND 36-Item Health Survey 1.0. Health Econ. 1993. p. 217–27.
7.
Ibrahim T, Beiri A, Azzabi M, Best A, Taylor G, Menon D. Reliability and validity of the subjective component of the American Orthopaedic Foot and Ankle Society clinical rating scales. J Foot Ankle Surg. 2007. p. 65–74.
8.
Ryan P, Johnston A, Gun B. Post-traumatic dynamic hallux varus instability. J Clin Orthop Trauma. 2014. p. 94–8.
9.
Solarino G, Solarino G, Bortone I, Vicenti G, Bizzoca D, Coviello M, et al. Role of biomechanical assessment in rotator cuff tear repair: arthroscopic vs mini-open approach. World J Orthop. 2021. p. 991–1000.
10.
Ripani U, Manzarbeitia-Arroba P, Guijarro-Leo S, Urrutia-Graña J, Masi-De Luca D, A. Vitamin C may help to reduce the knee’s arthritic symptoms. outcomes assessment of nutraceutical therapy. Med Arch. 2019. p. 173–7.
11.
Moretti L, Maccagnano G, Coviello M, Cassano G, Franchini A, Laneve A, et al. Platelet rich plasma injections for knee osteoarthritis treatment: a prospective clinical study. J Clin Med. 2022. p. 2640.
12.
Lui T. Stabilization of first metatarsophalangeal instability with plantar plate tenodesis. Foot Ankle Surg. 2008. p. 211–4.
13.
Pasquino A, Tomarchio A, Cruto D, Conteduca E, Longo J, Russi D, et al. Comparing hand strength and quality life of locking plate versus intramedullary k wire for transverse midshaft metacarpal fractures. Med Glas (Zenica). p. 316–21.

Citation

Authors retain copyright. This work is licensed under a Creative Commons Attribution 4.0 International License. Creative Commons License

 

Article metrics

Google scholar: See link

The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.