Review Question - QID 218687

Turf toe involves ruptures of the medial collateral ligament (B) as well as injury to the plantar plate and sesamoid complex.

Turf Toe is a hyperextension injury to the plantar plate and sesamoid complex of the big toe metatarsophalangeal joint that most commonly occurs in contact athletic sports. Diagnosis is made clinically with the inability to hyperextend the hallux MTP joint without significant pain and the inability to push off with the big toe. A vertical Lachman test will show greater laxity compared to the contralateral side. Treatment is rest, NSAIDs, taping, and stiff-sole shoe or walking boot in the majority of cases. Surgical repair is indicated for patients with progressive and persistent symptoms who fail nonoperative management.

Smith et al. reviewed turf toe. They reported that complete turf toe injuries are often debilitating and may require operative management to restore a pain-free, stable, and functional forefoot. They concluded that operatively treated grade 3 turf toe injuries may result in good clinical outcomes.

Covell et al. reviewed traumatic hallux valgus injury in the athletic population. They reported that overall, good operative results were obtained, with 74% of patients returning to their preinjury level of play at an average recovery time of 3.4 months. They concluded that traumatic hallux valgus is an increasingly common injury in the athletic population and represents a unique variant of turf toe. The impact of this injury cannot be overstated, as one-quarter of players were unable to return to play.

Anderson et al. reviewed foot and ankle injuries in competitive sports. They reported that close attention is required during an examination to accurately identify such injuries as turf toe, ankle injuries, tarsometatarsal (ie, Lisfranc) injuries, and stress fractures. They concluded that early diagnosis and management of these injuries are critical.

Figure A is an unlabeled illustration of the great toe anatomy. Illustration A is the corresponding labeled illustration.

Incorrect Answers:
Answer 1: Turf toe does not involve the interphalangeal joint.
Answer 3: This is the accessory sesamoid ligament.
Answer 4: This is the inter-sesamoid ligament.
Answer 5: This is the lateral sesamoid-phalangeal ligament.