Intra-articular ossicle in interphalangeal joint of the great toe and clinical implication

Abstract

Failure of closed reduction for an interphalangeal joint dislocation of the great toe resulted from an intra-articular ossicle interposed between the articular cartilages of the phalanges. The knowledge concerning the intra-articular ossicle is unclear. A study was thus carried out on 100 fresh great toes to document the appearance, number, size, and location of the intra-articular ossicle found in the interphalangeal joint of the great toe. Roentgenographic studies of the joint revealed 86% of bony mass representing either the sesamoid bone or the intra-articular ossicle. Anatomical studies revealed no sesamoid bone in the flexor hallucis longus tendon. There was 88% of intra-articular ossicle on the dorsal surface of the plantar capsule of the interphalangeal joint. A medial surgical approach to reduce the irreducible dislocation is thus suggested as easier and safer than other approaches.

Irreducible Dislocation of the Great Toe Interphalangeal Joint Secondary to an Incarcerated Sesamoid

“…The anatomy of the joint makes closed reduction difficult to achieve [ 15 ]. Suwannahoy et al [ 16 ] conducted a cadaveric study on 100 fresh great toes to document the appearance, number, size, and location of an intra-articular ossicle found in the IP joint space of the great toe. Radiographic studies of the joint revealed 86% of bony mass representing either the sesamoid bone or an intra-articular ossicle.…”

“…They found that the bony mass was found on the dorsal surface of the plantar capsule of the IP joint 88% of the time. The challenge in closed reduction is likely to be a result of the interposed plantar capsule with the sesamoid as can be deduced from the work of Suwannahoy et al [ 16 ].…”

Thoracic Limb Morphology of the Ring‐tailed Lemur (Lemur catta) Evidenced by Gross Osteology and Radiography

“…The ovoid ossicle seen at the inter‐phalangeal joint of digit 1 in all animals suggests that the ossicle is a normal anatomical finding in this species. It is most likely that the ossicle is intra‐articular as described for the great toe in humans (Suwannahoy et al., ) and should be differentiated from an avulsion fracture or intra‐articular mineralized body.…”

Osteology and Radiographic Anatomy of the Pelvis and Hind Limb of Healthy Ring-Tailed Lemurs (Lemur catta)

“…They are usually single and bilateral (Roukis and Hurless, 1996) although the presence of double ossicles has also been reported (Davies et al, 2003;Suwannahoy et al, 2012). In humans, they can be located plantarmedial, plantarlateral or plantar to the inter-phalangeal joint of the hallux and their shape varies from spherical, oval, elliptical, rectangular or triangular (Roukins and Hurless, 1996).…”