MP I Joint Giving Way–A Case Study

Lohrer, Heinz

doi:10.1177/107110070102200213

Cited by 10 publications

(22 citation statements)

References 6 publications

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“…After removing duplicate articles, 858 studies were screened using inclusion/exclusion criteria; of these, 12 studies were identified for the final analysis. 1 –6,10,12 –16 Individual participant data were available for 4 case reports 10,12,13,15 and 5 case series. 2,3,5,6,14 Aggregate data were collected for 3 studies and inputted for individual participant analysis.…”

Section: Resultsmentioning

confidence: 99%

Return to Sport After Turf Toe Injuries: A Systematic Review and Meta-analysis

Vopat

Hassan

Poppe

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background:The prevalence of turf toe injuries has increased in recent years. However, uncertainty remains as to how to optimally treat turf toe injuries and the implications that the severity of the injury has on outcomes, specifically return to sport (RTS).Purpose:To determine RTS based on treatment modality and to provide clinicians with additional information when comparing operative versus nonoperative treatment of turf toe injuries in athletes.Study Design:Systematic review; Level of evidence, 4.Methods:A systematic review and meta-analysis was performed using the PubMed/Ovid MEDLINE/PubMed Central databases (May 1964 to August 2018) per PRISMA-IPD (Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Individual Participant Data) guidelines. RTS, treatment, severity of injury, athletic position, and sport were recorded and analyzed.Results:Of 858 identified studies, 12 met the criteria for the final meta-analysis. The studies included 112 athletes sustaining a total of 121 turf toe injuries; 63 (52.1%) of these injuries were treated surgically, while 58 (47.9%) were treated nonoperatively, and 53.7% were classified by the grade of injury (grade I, n = 1; grade II, n = 9; grade III, n = 55). Overall, 56 (46.3%) injuries could not be classified based on the data provided and were excluded from the final analysis. The median time to RTS for patients treated nonoperatively was 5.85 weeks (range, 3.00-8.70 weeks) compared with 14.70 weeks (range, 6.00-156.43 weeks) for patients treated surgically (P < .001); however, there was variability in the grade of injury between the 2 groups. Similarly, patients who sustained grade II injuries returned to sport more quickly (8.70 weeks) than patients who had a grade I (13.04 weeks) or grade III injury (16.50 weeks) (P = .016). The amount of time required to RTS was significantly influenced by the athlete’s level of play (16.50 weeks for both high school and college levels; 14.70 weeks for professional level) (P = .018).Conclusion:The time to RTS for an athlete who suffers from a turf toe injury is significantly influenced by the severity of injury and the athlete’s level of competition. Professional athletes who suffer from turf toe injuries RTS sooner than both high school and college athletes. However, there are a limited number of high-level studies evaluating turf toe injuries in the athletic population. Further research is necessary to clearly define the appropriate treatment and RTS protocols based on sport, position, and level of play.

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Section: Resultsmentioning

confidence: 99%

Return to Sport After Turf Toe Injuries: A Systematic Review and Meta-analysis

Vopat

Hassan

Poppe

et al. 2019

Orthopaedic Journal of Sports Medicine

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“…Sahin et al (2004) defined this as on-going pain and instability despite 6 months of conservative management. Whereas Lohrer (2001) defined this as persisting symptoms after 3 weeks of conservative management. The lack of a standardised conservative management regime makes it difficult to define when conservative management has failed, due to the significant variability.…”

Section: Discussionmentioning

confidence: 99%

“…The plantar plate is a fibrous thickening of the plantar capsule which courses from a relatively weak attachment of the metatarsal head to a strong attachment to the proximal phalanx. Along with these structures the joint is dynamically stabilised by the flexor hallucis brevis and its associated sesamoids, adductor hallucis and abductor hallucis tendons (Lohrer, 2001).…”

Section: Anatomy and Biomechanics Of The Hallux Metatarsophalangeal Jmentioning

confidence: 99%

“…Fluoroscopic imaging can be used to provide a dynamic assessment of the metatarsophalangeal joint and sesamoid complex. Lack of distal sesamoid movement with hallux dorsiflexion is suggestive of plantar plate rupture (Lohrer, 2001). , Magnetic resonance imaging (MRI) should be used in all grade 2 and grade 3 turf toe injuries to identify osseous, articular or soft tissue injury, aiding in grading and treatment of turf toe injury.…”

Section: Anatomy and Biomechanics Of The Hallux Metatarsophalangeal Jmentioning

confidence: 99%

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The Management of Turf Toe – A Systematic Review

Hainsworth

McKinley

2018

Baltic Journal of Sport and Health Sciences

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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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“…To date, post-traumatic hallux valgus has been attributed to Lisfranc injury, 1 medial plantar neuropathy, 2 turf toe variant injuries, 3 first metatarsal fracture, 4 and medial collateral ligament (MCL) tears. 5,6 Rupture of the first metatarsal medial collateral ligament was initially described in 1997 in a professional soccer player. 7 Since then, there has been less than 10 reported documented cases of post-traumatic hallux valgus secondary to MCL tears.…”

Section: Introductionmentioning

confidence: 99%

Post-Traumatic Hallux Valgus: A Modified Surgical Technique

Gorica

McFarland

Lewis³

et al. 2022

Arthroscopy Techniques

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Post-traumatic hallux valgus, a turf toe variant, is a rare, yet limiting injury. According to the literature, the deformity has been associated with acute medial collateral ligament tears, turf toe variant injuries, Lisfranc injury patterns, and first metatarsal fractures. There have been few documented cases of post-traumatic hallux valgus secondary to medial collateral ligament tears, and the treatment has been variable. Some authors have described direct end-to-end repair of the ligament to address the deformity, while others have described a modified McBride bunionectomy involving a Silver bunionectomy, lateral soft tissue release, and medial capsular and ligamentous repair. We propose a modified technique similar to the modified McBride bunionectomy, however, with the use of an all-suture anchor in the medial capsular and ligamentous repair. Our belief is that the all-suture anchor will allow for a stronger repair that will meet the physical demands of everyday ambulation and athletic participation. We used this technique in an individual who had evidence of a medial ligamentous complex injury of the hallux on MRI and failed conservative management. Postoperatively, the patient is immobilized until they can begin working on range of motion, strengthening, and finally to achieve return to full activity and sports.

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MP I Joint Giving Way–A Case Study

Cited by 10 publications

References 6 publications

Return to Sport After Turf Toe Injuries: A Systematic Review and Meta-analysis

Return to Sport After Turf Toe Injuries: A Systematic Review and Meta-analysis

The Management of Turf Toe – A Systematic Review

Post-Traumatic Hallux Valgus: A Modified Surgical Technique

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