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Turf toe is a hyper-extension or impaction injury of the great toe joint that injures the joint cartilage and soft tissue structures supporting the great toe joint. Turf toe is most often described as a sports related injury but can also be caused by traumatic injuries such as industrial or motor vehicle injuries. Turf toe is found more in men than in women. Men between the ages of 20-50 years of age are most susceptible to turf toe.
Acute onset of pain at the time of injury
Bruising and swelling are common
Stiffness of the great toe that continues for weeks post injury
Difficulty walking due to limited range of motion of the great toe
Turf toe is a hyper-extension injury of the great toe. Hyper-extension damages the envelope of soft tissue structures surrounding the joint. One or more of the following structures may be injured;
- The plantar plate
- The inter-sesamoidal ligament (glenoid ligament)
- The plantar capsule
- The flexor hallucis brevis tendon proximal or distal to the sesamoid
Causes and contributing factors
Contributing factors include the use of weak shank shoes or wearing shoe not designed for the activity in which the injury takes place.
The differential diagnosis for turf toe includes;
Diagnosis of turf toe begins with a history of the injury and physical exam. X-rays are used to evaluate the integrity of the 1st metatarsal, base of the great toe, sesamoid bones and surrounding soft tissue structures. The diagnosis of turf toe requires a high sense of clinical suspicion based upon the location of the symptoms and description of the injury. MRI is an effective tool in determining the extent of injury to the soft tissue structures surrounding the joint.
Conservative treatment of turf toe includes rest, ice and use of anti-inflammatory medications. The use of a walking cast is common for 4-6 weeks following the injury. The walking cast will provide a flat, rocker surface that limits the range of motion of the great toe, enabling undisturbed healing. In severe cases, non-weight bearing casting may be used. A turf toe strap or turf toe plate is used for long term management of the injury to limit range of motion of the joint.
Surgical correction of turf toe is focused on repair of traumatic defects of the soft tissue envelope surrounding the joint. Surgical correction is usually followed with a period of casting and non-weight bearing along with physical therapy. The success of surgical correction of turf toe injuries depends in a great part upon the severity of the injury.
When to contact your doctor
Suspected turf toe injuries should be evaluated by your podiatrist or orthopedist.
Author(s) and date
Competing Interests - None
Peer Reviewed - This article is peer reviewed by an open source editorial board. Your comments and suggestions to improve this paper are appreciated.
Cite this article as: Oster, Jeffrey. Turf Toe. http://www.myfootshop.com/article/turf-toe
First published online: January 1, 2000. Most recently updated 3/20/2015.
Turf Toe by Myfootshop.com is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License.
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