Irreducible Dislocation of the Great Toe Interphalangeal Joint Secondary to an Incarcerated Sesamoid: A Retrospective Case Series of Six Patients

Introduction: Irreducible interphalangeal (IP) joint dislocation of the hallux is a rare injury, most often caused by interposition of the sesamoid–plantar plate complex. Diagnosis may be delayed due to subtle radiographs, and closed reduction is typically unsuccessful. Materials and Methods: This retrospective case series reports six patients (ages 25–60 years, 4 males and 2 females) who sustained dorsal or plantar hallux IP dislocations following sports injuries, falls, or crush trauma during 2 years. Four patients presented acutely, while one presented 3 weeks after injury. Closed reduction failed in all cases. Open reduction was performed in all patients, with temporary Kirschner-wire fixation. Results: No wound complications were noted; no extensor hallucis longus injuries were observed in any of the patients, and all of them healed well. The mean Visual Analog Scale (VAS) score pre-operative was 5.6, and the post-operative mean VAS score was 2.1; the mean time to return to work was 50 days. The follow-up (mean 6 months), four patients had full pain-free mobility, while two reported mild stiffness without functional limitation. Conclusion: Irreducible hallux IP dislocations should be suspected when deformity persists after trauma. True-lateral radiographs are essential for diagnosis. Open or percutaneous reduction with temporary fixation provides reliable long-term outcomes. Keywords: Hallux, interphalangeal joint, sesamoid, dislocation, open reduction, Kirschner-wire.