Turf toe: a review of mechanism, pathoanatomy and management

Abstract

Turf toe is characterized by sprain or disruption of the plantar capsuloligamentous structures of the first metatarsophalangeal joint and usually occurs due to injury during contact sports such as rugby and American football. The clinical presentation typically includes pain, swelling, and ecchymosis at the plantar surface of the first metatarsophalangeal joint, with associated weakness during push off. Diagnostic evaluation involves thorough physical examination, stressing of ligaments, and imaging with radiographs and magnetic resonance imaging. Treatment is based on classification, but is generally conservative, with surgical management being reserved for patients who fail to improve with non-operative methods. Chronic injuries may be associated with worse outcomes, and therefore early diagnosis and treatment is vital.