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Turf Toe / Dislocation of MTP


- 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 through the sesamoids;
           - closed reduction is usually possible

Turf-toe: an analysis of metatarsophalangeal joint sprains in professional football players.

Traumatic dislocations of the first metatarsophalangeal joint.   

Traumatic lesions of the metatarsophalangeal joint of the great toe in athletes.    

Dorsal dislocation of the first metatarsophalangeal joint.

Injuries to the metatarsophalangeal joint in athletes.   

Traumatic dislocations of the first metatarsophalangeal joint.    

Radiologic case study. Traumatic dislocation of the tibial sesamoid of the hallux.

How Do You Manage a Significant Turf Toe Injury?