Open AccessTHE MANAGEMENT OF TURF TOE – A SYSTEMATIC REVIEW
Author(s) -
Louis Hainsworth,
John McKinley
Publication year - 2018
Publication title -
baltic journal of sport and health sciences
Language(s) - English
Resource type - Journals
eISSN - 2538-8347
pISSN - 2351-6496
DOI - 10.33607/bjshs.v3i110.248
Subject(s) - medicine , conservative management , intervention (counseling) , physical therapy , athletes , conservative treatment , surgery , physical medicine and rehabilitation , psychiatry
Background. Turf toe is used to describe an injury occurring at the plantar aspect of the metatarsophalangeal-sesamoid complex of the hallux. Typically seen in athletes, it occurs due to hyperdorsiflexion and axial loadingof the hallux metatarsophalangeal joint with the foot fixed in equinus. The injury causes pain and joint instability,missed athletic activity and potentially end careers. Turf toe can be managed conservatively or operatively, withcontroversy regarding the indications for operative intervention. This study aims to conduct a systematic review todetermine whether and in what circumstances operative intervention is superior to conservative management of turftoe in adults.Methods. A systematic review of the literature was performed using PubMed, Embase, Cochrane andScopus databases. The search terms used were “turf toe”, “first metatarsophalangeal joint injury”, “conservative”,“nonoperative”, and “operative”. All articles published in English reporting on the management of turf toe werereviewed. The primary outcome measure was the time to return to pre-injury activity with the secondary outcome ofthe time to symptom resolution.Results. Seven studies met the inclusion criteria. Three patients were successfully managed conservativelyreturning to athletic activity, on average at 12 weeks. Seventeen patients underwent surgical intervention with anaverage return to athletic activity at 18 weeks.Conclusion. Operative intervention was shown to give a successful outcome in patients with grade three turftoe injuries or those who have failed conservative management. However, there is insufficient evidence to determinewhether operative intervention is superior to conservative management.