Surgical reconstruction in patients with a delayed presentation of TURF toe injury: early functional outcomes

M. Salim, R. Limaye, M. Alsayed, P. Karpe, A. Chauhan

Introduction: TURF toe is a hyperextension injury of the first metatarsophalangeal joint common amongst athletes. Axial loading of the dorsiflexed MTP joint in a well grounded forefoot results in the attenuation or disruption of the capsular ligamentous complex supporting the joint. This may lead to an unstable joint, fracture of the sesamoids or traumatic valgus deformity of the toe.

Aim: The aim of this study is to assess outcomes and complications following surgical treatment for delayed TURF toe presentation using the Manchester-Oxford foot questionnaire.

Materials and methods: Prospective data was collected for 7 patients who received surgery for delayed TURF toe presentation. All patients underwent a standardized process of care and all cases were operated on by a single foot and ankle surgeon. Functional outcome scores were measured using the MOxFQ and statistics were obtained using SPSS for Windows. Data was checked for normality, which confirmed a non-normal distribution. Subsequently, the non-parametric Wilcoxon signed rank test for paired data was used to test for statistical significance between the pre and post-operative scores.

Results: This study included 3 male and 4 female patients who had surgery between 2011 and 2015. Patients presented 12 to 18 months following initial injury. The mean age at the time of surgery was 32.7 years and mean follow up was 7.5 months post operative. 5 of the 7 patients had a history of hyperextension injury of the great toe. Improvements in all domains were statistically significant (P=< 0.05). The mean time to return to full functional capacity post-operative was 4 months, and no complications or reoccurrence of symptoms were documented following surgery.

Conclusion: This study demonstrated that good patient outcomes can be obtained with appropriate surgical treatment of TURF toe injuries with delayed presentation following a correct diagnosis and careful selection of surgical candidates.