Turf Toe & 1st MPJ Flashcards
What is turf toe?
hyperextension of 1st MPJ that causes tearing of plantar plate
what is hyperflexion of 1st MPJ called?
sand toe
Although ankle injury is 4x more common, turf toe accounts for more missed playing time.
true
foot injuries are 3rd most common injury in athletes, behind knee and ankle injuries.
true
When is turf toe seen?
(soccer or football player)
occurs when axial load is dellivered to a foot fixed in equinus
What are some causative factors of turf toe?
- soft soled shoes
- synthetic surfaces that have a higher coefficient of friction and limited shock absorption
Grade this: attenuation, swelling, minimal ecchymosis
grade 1 turf toe
what is treatment for grade 1?
symptomatic, carbon fiber plate
*return to play as toelrated
grade this: partial tear, moderate swelling, restricted motion due to pain
grade 2 turf toe
how would you treat grade 2?
walking boot/ crutches as needed
*up to 2 weeks benched from play
grade this: complete disruption, significant swelling/bruising, obvious instability, cartilage damage.
grade 3 turf toe
how would you treat grade 3?
long term immobilization
or surgery
when is surgical treatment for turf toe indicated?
if tear is present in soft tissues
what is predislocation syndrome?
a spectrum of disorders that covers any pain or strain on lesser MPJ (most commonly 2nd MPJ)
describe the attachments of plantar plate.
STRONGLY attached to base of proximal phalanx; LOOSELY attached to metatarsal head
what happens with rupture of plantar plate?
- proximal phalanx moves dorsally
- extensor tendons cannot extend PIPJ and DIPJ
what is the etiology of predislocation syndrome?
biomechanical defects- esp pronation due to equinus
*2nd MPJ affected usually
stage this: mild plantar and dorsal edema
- extreme tenderness with palpation
- no clinical anatomic alignment
stage 1 predislocation syndrome-
stage this: moderate edema; deviation of toe both clinically and radiographically (toe doesn’t touch ground)
stage 2 predislocation syndrome
stage this : moderate edema about entire circumference of MPJ, edema extends into toe, pronounced deviation with possible dorsal dislocation
stage 3 predislocation syndrome
treatment for predislocation syndrome?
conservative: shoe modifications, taping, off-loading, rest, ice
surgery is indicated when flexibility and reducibility of deformity are lost
what accounts for more missed playing time? ankle injury or turf toe
turf toe
what are some conservative treatment options for turf toe?
- orthotic
- stiff soled shoe
- taping
- offloading with crutches/boot
- NSAIDS to treat pain
