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

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.