Metatarsophalangeal Dislocation S93.129A 838.05

synonyms:MTP joint dislocation, toe dislocation, metatarsophalangeal joint dislocation

MTP Dislocation ICD-10

• S93.129A - Dislocation of metatarsophalangeal joint of unspecified toe(s), initial encounter
• S93.129D - Dislocation of metatarsophalangeal joint of unspecified toe(s), subsequent encounter
• S93.129S - Dislocation of metatarsophalangeal joint of unspecified toe(s), sequela

MTP Dislocation ICD-9

• 838.05 (closed dislocation of MTP joint)

MTP Dislocation Etiology / Epidemiology / Natural History

• rare
• Frank dislocation of the first MTP joint is almost always dorsal in direction.

MTP Dislocation Anatomy

MTP Dislocation Clinical Evaluation

MTP Dislocation Xray / Diagnositc Tests

MTP Dislocation Classification / Treatment

• Type I – These dislocations occur with disruption of the sesamoid-plantar plate complex through the relatively weak proximal attachments of the plate to the metatarsal neck.  There is no injury to the intersesamoid ligament, and the space between the sesamoids is not widened when viewed on the plain AP radiograph.  The sesamoids come to lie between the joint surfaces just dorsal to the metatarsal head, which can be visualized on a lateral radiograph.  This complex injury pattern is not reducible by closed means because the plantar plate is interposed into the MTP joint.  Open reduction is required through a transverse plantar incision or dorsal incision to remove the interposed plantar plate.
• Type II – These injuries involve a disruption of the sesamoid complex and are subclassified into IIA and IIB.  IIA dislocations show disruption of the intersesamoid ligament with widening of the space and dislocation of the metatarsal head through this space.(response 4)  IIB injuries produce a transverse fracture through one or both sesamoids.  The proximal fracture fragment remains in its normal relationship to the adjacent sesamoid held in place by strong intersesamoid ligament.  Frequently, the distal sesamoid fragment becomes a loose body within the joint and may require removal.
• Metatarsophalangeal Dislocation CPT Codes

MTP Dislocation Associated Injuries / Differential Diagnosis

MTP Dislocation Complications

• Nonuion
• Infection
• Painful hardware
• Compartment Syndrome
• CRPS
• DVT / PE
• Heterotopic Ossification

MTP Dislocation Follow-up Care

MTP Dislocation Review References

• Jahss MH:  Traumatic dislocations of the first metatarsophalangeal joint.  Foot Ankle 1980;1:15-21
• Schenck RC Jr, Heckman JD:  Fractures and dislocations of the forefoot:  Operative and nonoperative treatment.  JAAOS 1995;3:70-8.