The patient-reported outcomes after resection of a symptomatic Morton's neuroma are acceptable but may not be as good as earlier studies suggest. Surgery at several sites can be undertaken safely but caution should be exercised when considering revision surgery. Cite this article: Bone Joint J 2016;98-B:1376-81.
But if the incision cuts into the nerve ju t above the point of ongm of a branch the signs of complete division of that branch are produced. In certain ituations also-for example, in the anterior primary division of "the fifth cervical nerve-the nen•e fiber are arranged in a well-defined order, and incomplete division of this nerve may entail complete •division of those motor fiber which supply the spinati and the deltoid muscles. Again, in the trunk 3. ~farie, P.: Des resultats fournis par l'electrisation directe des troncs nerveux clan la plaie operatoire chez !es hie ses atteints de traumatismes des nerfs, Bull. de l'Acad. de med.
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 loading
of 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, with
controversy regarding the indications for operative intervention. This study aims to conduct a systematic review to
determine whether and in what circumstances operative intervention is superior to conservative management of turf
toe in adults.
Methods. A systematic review of the literature was performed using PubMed, Embase, Cochrane and
Scopus 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 were
reviewed. The primary outcome measure was the time to return to pre-injury activity with the secondary outcome of
the time to symptom resolution.
Results. Seven studies met the inclusion criteria. Three patients were successfully managed conservatively
returning to athletic activity, on average at 12 weeks. Seventeen patients underwent surgical intervention with an
average return to athletic activity at 18 weeks.
Conclusion. Operative intervention was shown to give a successful outcome in patients with grade three turf
toe injuries or those who have failed conservative management. However, there is insufficient evidence to determine
whether operative intervention is superior to conservative management.
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