Injury to the metatarsophalangeal joints in sports has become an increasing problem with the advent of more flexible shoewear and artificial playing surfaces. These injuries vary from mild sprains to severe tearing of the capsuloligamentous complex including avulsion fractures. This may include a compression fracture of the metatarsal head in the more severe cases. At the extreme, dislocation or fracture-dislocation of the metatarsophalangeal joint occurs. The findings in 62 cases of these injuries in Rice University athletes from 1971 to 1985 are presented. Treatment follows a standard regimen of ice, taping and anti-inflammatory medication with gradual return to sports activity as symptoms allow. Recommendations for preventive therapy include stiffening the forefoot in athletic shoes or the use of an orthotic device. This should reduce the incidence of long-term sequelae.
A prospective investigation covering 8 years (1971 to 1978) at a major university was undertaken involving the nonoperative management of medial collateral ligament injuries to the knee. Rigid diagnostic criteria were used for each injury prior to inclusion in a program of functional rehabilitation without cast immobilization. Eighty-nine fresh ligamentous injuries were reviewed. Thirty-eight knees required surgery. The remaining 51 knees were classified as isolated Grade I or Grade II injuries. Forty-two (80%) successfully completed the program of rehabilitation. Nine (20%) were considered failures. These were attributed to inadequate diagnoses during the early period of the study. Average time required for the athletes to return to full competition was 21 days (range of 9 to 32 days.)
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