Fracture-dislocation of the first metatarsophalangeal joint: open reduction through a medial incisional approach.

A case of traumatic fracture-dislocation of the first metatarsophalangeal joint is reported. This type of injury is extremely rare. The injury was associated with complete disruption of the following anatomic structures: conjoined tendon of abductor hallucis and medial head of flexor hallucis brevis, plantar plate, and the intersesamoid ligament. Additionally, there was a transverse fracture of the tibial sesamoid. Excision of the fractured tibial sesamoid trapped within the joint and primary repair was achieved through a medial incisional approach. A complete description of the repair and rationale for the surgical procedure is discussed.