Return to Sport and Clinical Outcomes Among Athletes Following Turf Toe Repair

Category: Midfoot/Forefoot; Sports Introduction/Purpose: Turf toe, a plantar plate injury of the first metatarsophalangeal joint, commonly occurs in athletes participating in outdoor cutting sports. To the knowledge of the authors, this study reports on clinical and return to sport outcomes after surgical repair of turf toe for the largest cohort of patients presenting with a Grade III turf toe injury. The purpose of this study is to identify risk factors for turf toe and analyze foot function after turf toe injury and surgical repair. This study reports on clinical outcomes and return to sport for athletic patients treated for a turf toe injury at our institution. We hypothesize that patients will have significant improvement in pre- to postoperative clinical outcomes and quickly return to sport after surgical repair. Methods: This was a single-center retrospective study conducted from the institutional review board-approved Foot and Ankle Registry data, and the protocol was approved by the steering committee at the investigators’ institution. Inclusion criteria included athletes of at least high school level competition who underwent plantar plate repair at the first metatarsophalangeal joint between 2016 to 2023 by 3 fellowship-trained foot and ankle orthopedic surgeons. Excluded were patients with histories of ipsilateral forefoot surgeries, rheumatoid arthritis, or gout. Twenty-eight patients were identified. Patient-reported outcomes via PROMIS scores were collected preoperatively and at least one year postoperatively for all patients. Return to sport surveys were distributed to patients at least one year postoperatively. Results: The average time from surgery to final follow-up was 2.8 (range, 1-5.3) years. PROMIS scores were found to significantly improve for Physical Function, Pain Interference, Pain Intensity, and Global Physical Health domains. 21 return to sport surveys were completed from the patient cohort. 19 out of 21 (90.5%) of patients were able to return to pre-injury levels of physical competition with an average time to return to sport was 20.35 (range, 12-32) weeks. Conclusion: This study compared short- to medium-term patient-reported clinical outcomes and return to sport data for athletes after a Grade III turf toe injury and surgical repair. Patients demonstrated significant improvement in patient-reported outcomes and were able to return to sport approximately five months after surgery.