- Discussion:
- turf toe is a tear of joint capsule from MT head which results in subluxation or dislocation of first MTP joint
- caused by hyperextension (most common), hyperflexion, or valgus injury;
- associated w/ decr ROM at first MTP joint & its sequele can include
hallux rigidus, and can exacerbate
sesamoiditis;
- turf toe can be extremely debilitating injury in competitive football player;
- Radiographs:
- with dislocation of the MTP joint without sesamoid fracture anticipate difficulty with closed reduction;
- Treatment of Hyper-extension Injuries:
- activities are reduced for 3 weeks, and afterwards the patient must wear an orthosis that blocks
dorsiflexion during atheletic activities;
- Dislocations:
- dislocations of hallux MTP joint are classified as based on x-ray appearance of the
sesamoids;
-
type I:
- plantar plate ruptures at its proximal attachment to metatarsal neck & dislocates w/ attached
sesamoids riding over metatarsal head;
- plantar plate-sesamoid complex follows the proximal phalanx;
- metatarsal head can buttonhole into the plantar capsule which prevents closed reduction;
- disruption of volar plate - sesamoid complex;
- no sesamoid frx;
- no widening of inter-sesamoid space;
- reduction is blocked by the interposed volar plate;
- open reduction is performed thru dorsal approach;
-
type IIa:
- widening of inter-sesamoid interval;
- closed reduction is usually possible;
-
type IIb:
- transverse frx thru the sesamoids;
- closed reduction is usually possible;
Turf toe: An analysis of metatarsal phalangeal sprains in professional football players.
Am J Sports Med 1990;18:280-285.
Rodeo SA, O'Brien S, Warren RF, et al:
Traumatic dislocations of the first metatarsophalangeal joint.
Jahss MH: Foot Ankle 1980;1:15-21.
Traumatic lesions of the metatarsophalangeal joint of the great toe in athletes.
TP Coker et al.
Am J. Sports Med. Vol 6. 1978. p 326-334.
Dorsal dislocation of the first metatarsal phalangeal joint.
Giannikas AC, Papachristou G, Papavasiliou N, et al:
J Bone Joint Surg (Br) 1975;57B:384-386.
Injuries to the metatarsophalangeal joint in athletes.
TO Clanton et al.
Foot Ankle. Vol 7. 1986. p 162-176.
Traumatic dislocations of the first metatarsophalangeal joint.
Jahss MH: Foot Ankle 1:15, 1980
