Traumatic lesions of the metatarsophalangeal joint of the great toe in athletes

Abstract

In the 1972, 1973, and 1974 football seasons at the University of Arkansas, 74 players sustained sprains of the ankle, producing a total of 152 missed practices and 6 missed games. Although only 18 injuries of the first metatarsophalangeal joint complex were seen, these later resulted in 92 missed practices and 7 missed games. This injury has been a significant problem for both the university and for most other major institutions, judging from a 70% response to 94 questionnaires sent to trainers of 94 large colleges and universities throughout the United States. It is the researchers opinion that the artificial turf surface, particularly as it ages, the shoes, and shoe fitting are all possible contributors to the incidence of the problem. Nonoperative treatment, whose hallmark is rest, is the treatment of first choice. Taping and splinting with a 0.51-mm spring steel splint with reinforcement, both pre- and postinjury, are beneficial. Injections of steroids or any other attempt to return the still painful athlete to activity are contraindicated. Late surgery, particularly in the event of capsular ruptures, as well as early repair, can be of benefit. The need to re-evaluate the shoes and playing surfaces in the light of this and other injuries is emphasized.

Turf toe –çimde parmak zorlanması

“…Bu çalışmalar, Grade I ve Grade II yaralanmalarda konservatif tedaviyi desteklemektedir. [1,[4][5]23] Anderson [23] , turf toe yaralanması olan 19 yüksek aktivite seviyeli, elit sporcunun dokuzunda cerrahi tedavi uygulamış ve sadece iki olgu tam atletik aktiviteye dönebilmiştir. …”

“…MTP burkulması ile karşılaşıldığı, 80 ulusal futbol ligi (NFL) takımında yapılan bir survey çalışmasında, futbol kariyerlerinde en az bir kez burkulma oranının %45 olduğu ve %83'nün de sentetik zeminde oluştuğu ortaya konulmuştur. [2,4,5] …”

Los sesamoideos de la articulación metatarsofalángica del primer dedo: una revisión sistemática

“…MTF) colaboran en la estabilidad intrínseca de esta articulación. Múl-tiples estudios 20,21 demuestran que el sesamoideo medial (tibial o interno) soporta mayores presiones y es más vulnerable a traumatismos directos que el lateral (peroneal o externo). Además el sesamoideo interno presenta diez veces más incidencia de fragmentación que el externo (bi, tri, o multipartito).…”

“…Se refiere una mayor incidencia de fracturas en sesamoideo medial, debido a que soporta más carga en plano axial 20,21 . Tienen mayor incidencia en deportistas jóvenes y de sexo femenino 48 .…”

The hallux sesamoids revisited

“…In addition to the trauma of routine weight bearing, mechanisms of injury include direct force, as in a blow to the joint from an object falling from a height [26]; chronic repetitive stress, as in ballet dancing [37] and long-distance running; and acute hyperextension of the metatarsophalangeal joint, seen not uncommonly in athletes, particularly football players, when tackled from behind on a plantar flexed foot [11]. Preexisting hallux valgus deformities may cause a lateral shift of the tibial sesamoid, making it more vulnerable to stress injury under the first metatarsal head [32].…”