- Usually due to forced hyperextension of great toe
- Often occurs on artificial turf (e.g. football)
- Pain and swelling at first metatarsophalangeal joint
- Grading
- Grade 1: First MTP capsule stretched
- Mild symptoms
- Athlete usually able to continue sports participation
- Grade 2: MTP plantar ligamentous complex partial tear
- Swelling and Ecchymosis
- MTP range of motion decreased
- Grade 3: MTP plantar ligamentous complex complete tear
- Significant swelling and Ecchymosis
- Significantly limited MTP range of motion
- Patient has difficulty even walking
- Great Toe XRay (weight bearing)
- Evaluate for conditions on differential diagnosis
- Hallux Rigidus
- Sesamoid Stress Fracture
- Metatarsal Fracture
- Avulsion Fracture
- Low grade sprains heal in weeks
- High grade sprains may require immobilization
- RICE-M
- Immobilize Grade 3 sprains for 1-2 weeks
- Follow with 4 to 6 weeks of relative rest
- Consider taping
- Consider rocker bottom sole to shoe
- Surgical intervention not usually indicated
- DeLee (2003) Orthopedic Sports Medicine, p. 2504-10
- Greene (2001) Musculoskeletal Care, AAOS, p. 516-7
- Title (2002) Orthop Clin North Am 33:587-98 [PubMed]