Turf Toe Injuries of the Hallux Metatarsophalangeal Joint

Injuries to the hallux metatarsophalangeal joint are not uncommon, particularly in the running athlete. One of the more common causes of hallux injuries is the product of a hyperextension force on a foot fixed to the ground. When the resultant injury is ligamentous, it has been termed “turf toe.” Unfortunately, nearly any sprain of this joint, regardless of mechanism or severity has been given this label. Furthermore, trainers and physicians may fail to recognize the potential dysfunction of this injury, thus providing inadequate care and protection from further injury. Long-term sequelae include FHL tendon tear, hallux valgus or varus, cock-up deformity with IP joint contracture, and degenerative joint disease. While the majority of these injuries can be treated nonoperatively, those with significant instability need to be recognized and surgically managed to allow for restoration of the anatomy and the opportunity for return to full function.