Complex Irreducible Dislocation of the Fourth Toe Proximal Interphalangeal Joint in a 5-year-old Boy Fixed by Soft Anchor: A Case Report.

INTRODUCTION: Irreducible lesser-toe interphalangeal joint dislocation in children is rare, but may cause pain, recurrent dislocations, and soft-tissue injury. The optimal method of fixation remains unclear. We present the first-ever reported case of an irreducible fourth toe proximal interphalangeal joint dislocation in a 5-year-old boy, successfully fixed with JuggerKnot™ soft mini-anchor. CASE REPORT: A 5-year-old boy with a crush injury to his left fourth toe, shown persistent dorsolateral dislocation of the proximal interphalangeal joint. Intraoperatively, close reduction failed, and we found a complete tear of the medial collateral ligament to be the culprit of the complex dislocation. It was repaired with the JuggerKnot™ soft mini-anchor and tied down to the proximal phalanx. CONCLUSION: This rare case illustrates the technique of soft mini-anchor in fixing irreducible dislocations with ligamentous injuries. It is safe and effective in children with similar injuries because it is one-staged operation that does not disrupt the growing cartilage and preserves joint motion.