foot/ankle TURF TOE
DEFINITION:
- A sprain of the first metatarsophalangeal (MTP) joint of the foot. (See illustration).
- Increased incidence when fields began to use artificial turf.
MECHANISM OF INURY / HOW IT OCCURS:
- A result of hyperextension of the first MTP joint of the foot but can occur with forced hyperflexion.
- Often seen in football linemen.
SYMPTOMS:
- Individuals complain of pain, swelling, and limited motion of the first MTP joint.
- Depending on extent of sprain, may have difficulty walking with a normal gait.
DIAGNOSIS:
- Physical examination reveals tenderness around the MTP joint which is exacerbated with extremes of motion.
- Swelling and occasionally bruising (ecchymosis).
- Radiographic studies such as plain x-rays are useful to evaluate for possible fracture or arthritis (hallux rigidus). Magnetic resonance imaging (MRI) sometimes utilized to assist with the diagnosis.
TREATMENT/REHABILITATION:
- Rest, ice, and elevation are the initial modalities utilized.
- Crutches to unload the joint is occasionally required.
- Splinting, orthotics, firm shoe, and taping to reduce forefoot motion.
- Early range of motion exercises.