Toe fractures are one of the most common fractures in the foot. They commonly occur when something heavy lands on the front of the foot or if a person stubs their toe against a hard object. These can be extremely painful and can make walking difficult.
A frequent misconception about toe fractures is that they do not require medical attention because there is nothing that can be done about them. This is incorrect.
Although most toe fractures do not require surgery, many of them will need to be set straight to ensure proper healing. A small percentage of toe fractures will do best with surgery using pins or screws to repair the fracture
A fractured toe will be swollen and tender. There is usually bruising present and the discoloration may extend to other toes as well. If there is any bleeding around the toe or beneath the nail, this may be an open (compound) fracture which requires immediate medical attention.
The toe may appear crooked or misaligned. If this is not straightened and the toe heals in an incorrect position the patient may develop pain, rubbing, corns, or ingrown nails.
X-rays of the foot should be taken to confirm whether a fracture is present. The orthopedic foot and ankle specialist should be consulted if the fracture is badly misaligned, if it involves the joint, or if it is an open fracture.
Non-surgical Treatment for Toe Fractures
Toe fractures that are reasonably well aligned and do not need straightening can be treated with “buddy-taping” and a hard soled post-operative shoe. These injuries will usually take four to six weeks to heal before the patient can transition comfortably into wide sneakers. Swelling may persist for up to a year.
The orthopedic foot and ankle specialist may recommend that the toe fracture be straightened if it is too angulated. This can be done in the office or emergency room using local anesthetic injections to numb the broken toe. The numb toe is then straightened manually and buddy-taped to the neighboring toe. X-rays are repeated to make sure that the alignment has improved.
Surgical Treatment for Toe Fractures
Surgery is necessary only if the fractured toe cannot be kept straight or if the fracture goes into the joint surface where the toe bends. Fractures involving the joint can lead to arthritis if not treated correctly. The broken bone and joint are re-aligned and held in position by either pins or screws.
Surgical treatment for toe fractures is also recommended for open or compound fractures that have broken through the skin. These cases can lead to bone infection if not washed out urgently. After cleaning the wound thoroughly, the toe is usually held straight with a pin that is removed later.