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Article
December 6, 1913

A CASE OF DISLOCATION OF PROXIMAL PHALANX OF GREAT TOE

Author Affiliations

Philadelphia

JAMA. 1913;61(23):2063. doi:10.1001/jama.1913.04350240037016

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Abstract

P. W., male, white, laborer, aged 56, reported at the surgical outpatient department of the University Hospital, service of Dr. B. A. Thomas, May 28, 1913, with the history of having been kicked by a horse nine weeks previously, and of having been treated at another hospital for an injury to the left knee. He now complains of pain in great toe. Examination reveals fixation of great toe in extreme extension and crepitation at metatarsophalangeal joint. The roentgenogram (Fig. 1) shows displacement of proximal phalanx of hallux onto the dorsum of the head of its metatarsal. The antero-posterior view (Fig. 2) is of interest in showing concomitant displacement of the sesamoids from the plantar aspect to each side of the joint. Under nitrous oxid reduction was attempted by means of Levis' apparatus, but owing to laceration of the skin this method was abandoned. A trial was next made of the

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