Return to Sport and Radiographic Postoperative Outcomes After Grade 3 Turf Toe Surgical Repair.

Background: Turf toe is a plantar plate injury of the first metatarsophalangeal joint that commonly occurs in athletes participating in outdoor cutting sports. However, there is a lack of evidence-based consensus on treatment guidelines and surgical outcomes in the current literature.

Purpose/hypothesis: The purpose of this study was to report on postoperative clinical outcomes and return to sport for athletic patients treated for both acute and chronic grade 3 turf toe injuries at the authors' institution. It was hypothesized that patients would have significant improvement in pre- to postoperative clinical outcomes and quickly return to sport after surgical repair.

Study design: Case series; Level of evidence, 4.

Methods: The records of patients who received plantar plate repair at the first metatarsophalangeal joint between February 2016 to July 2022 by 3 fellowship-trained foot and ankle orthopaedic surgeons were reviewed. Inclusion criteria included athletes of at least high school-level competition who underwent plantar plate repair for a primary diagnosis of turf toe injury. Excluded were patients with histories of ipsilateral forefoot surgeries, rheumatoid arthritis, or gout. In total, 28 patients were identified and screened for inclusion. Patient-reported outcomes via Patient-Reported Outcomes Measurement Information System (PROMIS) scores were collected preoperatively and at least 1 year postoperatively for all patients. Return-to-sport data were collected via telephone call. Bilateral preoperative and postoperative radiographs were analyzed to measure preoperative and postoperative sesamoid diastasis.

Results: The improvement in pre- to postoperative PROMIS scores was found to be significant for Physical Function, Pain Interference, Pain Intensity, and Global Physical Health. A total of 21 return-to-sport surveys were completed from the patient cohort. Nineteen of 21 (90.5%) of patients were able to return to preinjury levels of physical competition. The mean time to return to sport was 20.4 weeks (range, 12-32 weeks). Both medial and lateral sesamoids demonstrated a significant pre- to postoperative improvement in sesamoid diastasis. No difference in outcomes was observed between acute and chronic injuries.

Conclusion: Patients who received plantar plate repair for a grade 3 turf toe injury demonstrated significant improvement in patient-reported outcomes and were able to quickly return to sport at a high rate.