Acute Isolated Irreducible Proximal Interphalangeal Joint Dislocation of the Fifth Toe in a Toddler: A Case Report

A male child aged three years and three months presented after stubbing his right fifth toe. Imaging revealed a dorsolateral dislocation of the proximal interphalangeal joint (PIPJ). After failed attempts at closed reduction, open reduction and internal fixation was pursued. At the one-year follow-up, the patient was found to be doing well clinically and radiographically. These types of injuries require a high degree of clinical suspicion to obtain the proper imaging. The interposition of adjacent soft tissues can render these injuries irreducible. When irreducible, open reduction and pin fixation may be appropriate after an adequate trial of closed reduction under anesthesia. Concomitant ligamentous injuries, avulsion injuries, and fracture-dislocations often accompany these injuries; however, they can also occur in isolation.