Metatarsalphalangeal Joint Sprain

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 Definition Turf toe is an injury to the joint capsule and ligaments that connect the foot to the big toe.
Details Turf toe injuries are divided into three grades by severity.

Grade I: Stretch of the joint capsule and ligaments
Grade II: Partial tear of the joint capsule and ligaments
Grade III: Complete tear of the joint capsule and ligaments

The severity of the injury usually predicts the length of time lost to playing.
Causes Hyperextension of the joint that connects the foot to the big toe is the primary cause of turf toe. As its name implies, turf toe is associated with playing sports on rigid surfaces such as artificial grass. Hyperflexible shoes may also predispose athletes to this type of injury. Turf toe is most commonly associated with football.
Diagnosis Turf toe is diagnosed by a history of a hyperextension injury to the big toe. This history is accompanied by pain, tenderness and swelling. In the higher grades of injury, bruising and restriction of motion is seen. X-rays of the foot are taken to rule out fractures. Rarely, an MRI or bone scan may be used to rule out other causes of foot pain.
Treatment Nonoperative: Turf toe should initially be treated with icing, rest and anti-inflammatory medication. Taping of the toe to prevent hyperextension and use of a stiff insole insert in the shoe are important components of treatment.

Operative: Rarely, surgery is indicated to repair the capsule or ligaments of the big toe joint. This type of treatment should be reserved for only severe cases that fail to respond to nonoperative treatment measures..

Playing on natural grass, use of stiff insole inserts or taping of the big toe to prevent hyperextension may prevent some cases of turf toe.