Periarticular injuries to the hallux metatarsophalangeal joint in athletes

The magnitude of hallux MTP injuries can range from a mild sprain to a frank dislocation. The importance of coaches, trainers, and physicians recognizing the severity of a turf toe injury cannot be overstated. The late sequelae of hyperextension injuries can lead to retirement from professional athletics. With appropriate conservative treatment, most individuals can return to play, although many have some residual pain. Future study in this area should define the indications for acute repair versus late treatment following a period of conservative modalities. Hyper-plantarflexion injuries also can be debilitating injuries, but most respond to rest, taping, anti-inflammatories, ice, and strengthening exercises. Lastly, dislocations of the hallux MTP joint can be diagnosed and treated after physical examination and appropriate radiographs are obtained. All closed dislocations should undergo an attempt at reduction in the emergency department after adequate anesthesia is administered. The patient should be advised, especially in type I injuries, of the need for possible acute operative intervention.