The term turf toe refers to hyperextension injuries of the first metatarslophalangeal joint, originally described in football players on artificial turf (“astroturf”).
Anatomy: The sesamoid bones are fixed proximally by thin, usually invisible metatarso-sesamoid ligaments and distally by strong sesamophalangeal ligaments. In addition, the tendons of the two heads of the flexor hallucis brevis muscle attach proximally into the sesamoid bones. Laterally, they are connected to the capsule by the accessory collateral ligaments. The abductor hallucis tendon merges laterally with this complex and the adductor hallucis tendon and the deep transverse intermetatarsal ligament medially. A strong intersesamoid ligament runs between the sesamoid bones. From this ligament a thin capsular structure, which covers the flexor hallucis longus tendon, extends to the base phalanx. Some authors refer to this entire plantar complex as the “plantar plate” of the greater toe [Crain JM et al., Ashimolowo T et al.] others only to the thin central part between the sesamophalangeal ligaments [Nery C et al.].
Due to this inconsistent nomenclature, it is recommended not to use the term “plantar plate” at the big toe, but to refer directly to the structures of the above-mentioned capsuloligamentous-sesamoid complex.
As with the other toes, injuries to the plantar capsule can extend into the collateral ligaments.