20577991 tn?1501111823

Great and second toe injury a year ago. Still painful with limited range of motion.

Approximately 1 year ago I tried to jump over an object while sprinting and instead ran my foot into the object. I initially did no go to the doctor and simply taped the second toe to the great toe and took about 6 weeks off exercising etc. I finally went to a doctor about 6 months later because I was still having pain and swelling at the proximal end of the second toe and I am unable to curl my great toe. I was sent for an MRI which showed a fracture of the neck of the proximal phalanx of second toe without joint involvement. I tried a gate plate for 10 weeks but the fx remained. Then  was put in a walking boot for 12 weeks. I was still having pain so the DPM had me go non-weight bearing for 6 weeks. The pain has continued so I was sent for a bone scan. The bone scan showed that the FX is healed. I was sent for a second opinion with an ortho surg and he stated that he thinks I tore a tendon on the underside of my great toe and ruptured the plantar plate of the second toe. Currently he has me on light exercise and regular weigh bearing for four weeks. He does not want to repair any of the injuries.

On exam I can pull upwards all toes and push down with all toes. The great and second toes pushing down is notably weaker. The joint between the middle and proximal phalanx has limited ROM and pain with manual manipulation. The PMJ of the second toe also has limited ROM but minimal pain with manual manipulation. The great toe distal and middle phalanx joint can be manually moved without pain but I can not move that joint myself.

I am curious of others opinions, Also, perhaps someone could explain what tendons/ligaments I may have injured that curl the most distal joint of the great toe. The MPJ of the second toe is where the majority of my pain is. Will it simply resolve over time?

I am about to start CRNA school in a month and if I have surgery it would need to be soon.

Thank you for your time and information!
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