Broken Toe

Broken Toe Overview

Another name for a broken toe is a toe fracture. Each toe is made up of several bones. One or more of these bones may be fractured after an injury to the foot or toes.

Broken Toe Causes

Broken toes usually result from some form of trauma or injury to the foot or toe. Injuries such as stubbing a toe or dropping a heavy object on a toe may cause a fracture. Sometimes, a broken toe may result from prolonged repetitive movements, as in certain sports activities. This is called a stress fracture.

Broken Toe Symptoms

• After the injury, pain, swelling, or stiffness can occur. Bruising of the skin around the toe may also be noticeable. The toe may not look normal, and it may even look bent or deformed if the broken bone is out of place. It may be difficult to walk because of the pain, especially if the big toe is fractured.
• Shoes may be painful to wear or feel too tight.
• Some other problems may develop in addition to, or as a result of, the fracture. These complications can occur right away after the injury (minutes to days), or can happen much later (weeks to years).
  • Immediate complications
    • Nail injury: A collection of blood may develop underneath the toenail called a subungual hematoma. If it is large, it may have to be drained. To drain a subungual hematoma a doctor will make a small hole in the toenail to drain the blood out. If the hematoma is very large or painful, the entire toenail may need to be removed.
    • Open fracture: Rarely, the broken bone in a toe fracture may stick out through the skin. This is called an open or compound fracture. Careful cleansing of the wound and possibly antibiotic medication will be needed to prevent the bone from becoming infected. Sometimes surgery may even be necessary.
  • Delayed complications
    • After the toe fracture heals, the person may still be left with arthritis, pain, stiffness, or even a deformity.
    • Sometimes, the fractured bone will not heal completely (called a nonunion), or will heal improperly (called a malunion). Although it’s rare, surgery may be necessary to fix this problem.

When to Seek Medical Care

The injured toe should be looked at every day. Call a doctor if any of the following occur:

• Worsening or new pain not relieved by pain medication and the measures described in the treatment section
• Sores, redness, or open wounds near the injured toe
• A cast or splint is damaged or broken

Go to a hospital’s emergency department if the following signs or symptoms are present:

• Cold, numb, or tingling toes
• Blue or gray-colored skin
• Open wounds, bleeding, or drainage from near the broken toe

Exams and Tests

A doctor will ask some questions to determine how the toe was injured. Then the doctor will examine the injured toe and should also make sure there are no other injuries.

It is best to seek medical evaluation soon after the injury to ensure proper treatment and healing.

• A doctor may take an X-ray to see if a toe is broken or fractured.
• X-rays are not always necessary to make the diagnosis of a broken toe, especially if the break is in one of the smaller toes.

Broken Toe Treatment Self-Care at Home

These are things that can be done at home to help decrease the pain and swelling and to help the fracture heal properly.

• Elevation
  • Swelling that occurs after the injury worsens pain.
  • To help decrease the swelling (and the pain), keep the foot raised above the level of the heart as much as possible.
  • Prop the foot up on some pillows, especially when sleeping. Reclining in a lounge chair is also helpful.
• Ice
  • Put ice in a plastic bag and apply it to the injury for 15-20 minutes every 1-2 hours for the first 1-2 days.
  • Make sure to place a towel between the skin and the bag of ice to protect the skin.

• Rest
  • Avoid any strenuous exercise, prolonged standing, or walking.
  • Crutches may be needed, or a special shoe to wear when walking to avoid putting weight on the fracture while it heals.

Medical Treatment

Depending on the location and severity of the toe fracture, the fracture may need to be reduced (put back into place) and splinted or casted. If there is an open wound near the injured toe, a tetanus shot and antibiotic medication may also be necessary.

Medications

Pain medications

• Usually only acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) is needed for pain.
• Talk to the doctor before taking any new medications.
• For a severe fracture, the doctor may prescribe something stronger.
• Pain may be helped by elevating the foot and using ice packs.

Other Therapy

• Reduction
  • If the toe fracture is displaced (the 2 ends of the broken bone are out of place) or rotated (the toe is pointing in the wrong direction), the doctor may need to reduce it, or put it back into place.
  • Sometimes a shot of medication (called local anesthesia) may be needed to numb the toe before it is put back into place.
  • After a reduction, the broken bone will need support to hold it in place while it heals.
• Buddy taping
  • If the toe fracture is a minor or small fracture in a bone of one of the small toes, a doctor may only need to tape the injured toe to the one next to it for support. This treatment is also called buddy taping.
  • If the toe is buddy taped, it is usually safe to bathe, and then replace the tape afterward, but check with the doctor to make sure it is OK.
  • Make sure to put a small piece of cotton or gauze between the toes that are taped together. This prevents the skin between the toes from developing sores or blisters.
• Casting
  • A cast is usually not required for a simple toe fracture.
  • A hard-soled, sturdy, and supportive shoe should be worn.
  • A doctor may suggest a special shoe to wear if the foot or toes are very swollen.
  • A cast (or even surgery) may be needed if the big toe is broken, a fracture involves a joint, or a lot of small toe fractures occur at once.
  • A cast may also be needed if a bone in the foot or leg is broken in addition to the toe.

Next Steps Follow-up

Talk to the doctor to find out when to schedule an appointment to have the injured toe re-checked to make sure it is healing properly. If any problems or complications develop sooner, the appointment should be scheduled sooner.

Prevention

To help prevent an injury resulting in a broken toe, sturdy and supportive shoes should be worn.

Outlook

Broken toes usually take about 6 weeks to heal. If problems last longer than 6 weeks, another X-ray may be needed, or the injury should be rechecked by the doctor to see how the bone is healing.

Simple fractures usually heal well with no problems. However, a very bad fracture or a fracture that goes into a joint is at risk for developing arthritis, pain, stiffness, and possibly even a deformity.

For More Information

American College of Foot & Ankle Orthopedics and Medicine
5272 River Road, Suite 500
Bethesda, MD 20816
(888) 843-3338

https://www.acfaom.org

American Academy of Orthopaedic Surgeons (AAOS)
9400 W. Higgins Road
Rosemont, IL 60018

(847) 823-7186

https://www.aaos.org/home.asp

Synonyms and Keywords

toe fracture, metatarsal fracture, phalanx fracture, broken toe, foot trauma, foot injury, nail injury, subungual hematoma, open fracture, compound fracture, displaced toe fracture, rotated toe fracture, buddy taping, stress fracture

How to Treat a Broken Pinky Toe: 11 Steps (with Pictures)

About This Article

Medically reviewed by:

Board Certified Critical Care Surgeon

This article was medically reviewed by Jonas DeMuro, MD. Dr. DeMuro is a board certified Pediatric Critical Care Surgeon in New York. He received his MD from Stony Brook University School of Medicine in 1996. He completed his fellowship in Surgical Critical Care at North Shore-Long Island Jewish Health System and was a previous American College of Surgeons (ACS) Fellow. This article has been viewed 96,944 times.

Co-authors: 5

Updated: September 16, 2021

Views: 96,944

Medical Disclaimer

The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment.

Article SummaryX

To treat your broken pinky toe, your first priority will be reducing any swelling. To do this, keep your leg raised on a chair or cushion while sitting down. Avoid wearing shoes until the swelling’s gone down, since this can make it worse. For the first 24 hours, hold an ice pack wrapped in a towel to your toe for 20 minutes every hour. If your toe feels numb or tingles for a prolonged period of time, visit a doctor, since there might be complications with the break. After the first day, place a cotton ball between your pinky and the next toe, then tape the 2 toes together. This will help support your pinky while it heals. When you can walk without irritating your broken pinky toe, try going for short walks so you don’t put too much pressure on it. If your toe becomes swollen again, keep it raised and apply an ice pack again. For more tips from our Medical co-author, including how surgery can fix a severely broken toe, read on.

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Your Guide On How to Recover From a Broken Toe

I remember exactly what happened the day I broke my toe. I was walking down my hallway barefoot when I stubbed my pinky toe so hard against a door frame that I saw stars. I hobbled back to my bedroom and refused to look at the damage for hours. If you’ve ever stubbed your toe too hard, you’ll know that the immediate, severe pain can bring you to your knees and make you wonder if it’s broken. In many cases, the injury is simply a sprain, but it can be hard to know the difference between a sprain and a broken toe without medical attention. 

When I broke my toe, I didn’t recognize the symptoms of it right away – I just knew that my pinky toe hurt a lot. But, learning to recognize the symptoms and treatment of a broken toe is important for your immediate next steps it needs to heal. If a broken toe is left untreated, it can lead to permanent issues that can affect how you walk and run. And, at the very least, unattended broken toes can leave you in a lot of avoidable pain.

I don’t want you to have to go through either of these scenarios, so follow along as I detail how to know if a toe is broken, what you can do to ensure a speedy recovery, and things to consider once it’s healed.  

How to Know If You Have a Broken Toe

Stubbing or dropping something heavy on a toe is very common and it never feels good, but most of these incidents are nothing more than a minor inconvenience. But, sometimes it goes well beyond that. The first clue that something is actually wrong with your toe is the immediate and severe pain that comes and stays for a prolonged period of time. Another, less common, clue that something is wrong is actually hearing the break happen. 

Other general symptoms of a broken toe are:

• Throbbing pain at a specific point of the toe
• Swelling
• Bruising
• Difficulty putting weight on the toe
• Toe resting at an unnatural angle
• Stiffness

If you’re experiencing any of these symptoms, it’s a good idea to pay a visit to your doctor or a local emergency room as soon as possible. Once a break happens, it’s going to immediately try to heal itself, which can cause even more problems down the road if it doesn’t heal properly.  

Once you’re at the hospital, the medical staff will perform initial diagnostic tests and get your medical history. Be sure to tell your doctor as many details as you can about the injury and your symptoms so they’ll have a clear picture of what they’re working with. Also, let them know if you’re experiencing a loss of feeling or a tingling sensation in your toe because it may be a sign of nerve damage.

After you’re admitted, the only way to really diagnose a broken toe is to get an x-ray taken of the afflicted digit. The technician will likely get multiple angles of your toe to make sure that they can see the damage from all sides. If there’s a chance the toe is broken, the doctor will be able to diagnose how severe the break is and recommend treatment options to you.

Healing and Treatment Options

So, I have good news and bad news. The good news is that, in most cases, broken toes are relatively clean breaks, which means that they won’t require surgery or extensive intervention to heal. Unfortunately, however, there’s not much a doctor can do in those cases. The best way to heal your broken toe is by keeping it stable and elevated while periodically applying ice to your toe for 10-20 minutes to help manage any swelling.

Splinting 

The typical treatment for a broken toe is called buddy taping. With buddy taping, you apply gauze around the broken toe, secure it carefully to the toe next to it with medical tape, and place a gauze pad in between the toes to prevent skin irritation. The non-broken toe helps keep the broken one stable as you walk around, giving it the support it needs to begin healing properly. 

Surgery and Additional Treatments

Some toe breaks aren’t as straight forward, and if you have bone fragments that need to heal, taping may not be enough. In these cases, you’ll need to wear a walking cast to ensure that your toe has extra stability while walking.

In very serious cases, you may need surgery to reset the broken bones. In this process, the surgeon will sometimes put a pin or a permanent screw into the bone to help it heal properly.

Recovering From a Broken Toe

As your toe heals, it’s likely going to be tender and swollen. Try to avoid activities such as running, playing sports, and walking long distances for a couple of months to ensure that your bone has the best chance to heal. Basically, just take it easy and continue to rest, elevate, and ice your toe. Recovery time can vary based on the location and severity of your injury, but you’ll generally be back on your feet (pun intended!) within six weeks. 

If the toe injury is severe enough, your doctor may recommend going to see a physical therapist, These specialists will then give you a series of exercises that will help strengthen your toe and maximize its range of motion.

Lasting Impact

Ultimately, broken toes aren’t that big of a deal, but they need to be taken seriously so you can fully heal. The key to a good outcome is following your doctor’s advice. After a couple of weeks, you can start to carefully put more pressure on your broken toe each day to see how it’s recovering. Take any slight improvements in pain and discomfort as signs that your injury is healing. 

Eventually, start to ease back into your activities. But, don’t forget to listen to your body and back off on your activity if something doesn’t feel right. After all, it’s better to take longer to recover than to rush back into your activities too quickly and injure yourself all over again. 

I hope my guide helped you! Have you ever broken your toe? If so, let me know your recovery process in the comments below! 

Open Toe Fracture

Your big toe is broken (fractured) and you have a nearby cut (laceration), puncture, or deep scrape. This causes pain, swelling, and bruising at the site of the injury. Because of the open injury, you are at risk for an infection in the skin and bone. You will be given antibiotics to lower the risk for infection.

Any cut will take about 10 days to heal. The fracture takes about 4 weeks to heal. Toe injuries are often treated by taping the injured toe to the next one (buddy taping) or using a protective boot. This protects the injured toe and holds it in position.

If the toenail has been severely injured, it may fall off in 1 to 2 weeks. It takes up to 12 months for a new toenail to grow back.

Home care

These guidelines will help you care for your wound at home:

• You may be given a cast shoe or boot to wear to keep your toe from moving. If not, you can use a sandal or any shoe that doesn’t put pressure on the injured toe until the swelling and pain go away. If using a sandal, be careful not to strike your foot against anything. Another injury could make the fracture worse. If you were given crutches, don’t put your full weight on the injured foot until you can do so without pain.

• Keep your foot elevated to reduce pain and swelling. When sleeping, put a pillow under the injured leg. When sitting, support the injured leg so it’s above your waist. This is very important during the first 2 days (48 hours).

• Put an ice pack on the injured area. Do this for 20 minutes every 1 to 2 hours the first day for pain relief. You can make an ice pack by wrapping a plastic bag of ice cubes in a thin towel. As the ice melts, be careful that any cloth or paper tape doesn’t get wet. Continue using the ice pack 3 to 4 times a day for the next 2 days. Then use the ice pack as needed to ease pain and swelling.

• You may use acetaminophen or ibuprofen to control pain, unless another pain medicine was prescribed. If you have chronic liver or kidney disease, talk with your healthcare provider before using these medicines. Also talk with your provider if you’ve had a stomach ulcer or gastrointestinal bleeding.

• If buddy tape was used and it becomes wet or dirty, change it. You may replace it with paper, plastic, or cloth tape. Cloth tape and paper tapes must be kept dry. Keep the buddy tape in place for 4 weeks, or as instructed.

• Keep the wound clean and dry. If a bandage was put on and it becomes wet or dirty, replace it. Otherwise, leave it in place for the first 24 hours.

• If stitches were used, clean the wound every day:

  • Take off the bandage. Wash the area with soap and water. Use a wet cotton swab to loosen and remove any blood or crust that forms.

  • After cleaning, put a fresh bandage on.

  • You may take off the bandage to shower as usual after the first 24 hours. But don’t soak the area in water until the stitches are removed. Don’t take a tub bath or go swimming during this time.

• If surgical tape was used, keep the area clean and dry. If it becomes wet, blot it dry with a towel.

• Take any prescribed antibiotics until they are gone.

• You may go back to sports or physical activities after 4 weeks, or when you can run without pain.  Stay away from the activity that led to the injury during this time. Choose another activity in the meantime. Gradually go back to your usual activities. Stop any activities if the pain comes back.

• You may need surgery for more severe injuries, but this is rare. If so, this is done by an orthopedic surgeon. This is a surgeon who specializes in treating bone, muscle, joint, and tendon problems.

Follow-up care

Follow up with your healthcare provider, or as advised. This is to make sure the bone is healing the way it should. Most skin wounds heal within 10 days. But even with proper treatment, a wound infection may sometimes occur. That’s why it’s important to check the wound every day for signs of infection listed below.

Stitches should be removed in 7 to 14 days. If surgical tape closures were used, you can take them off yourself if they haven’t fallen off after 10 days.

You will be told of any new findings that may affect your care.

When to get medical advice

Call your healthcare provider right away if any of these occur:

• Redness, warmth, swelling, drainage from the wound, or foul odor

• Chills or fever of 100.4ºF (38ºC) or higher, or as directed by your healthcare provider

• Stitches come apart or surgical tape closures fall off before 7 days

• Wound edges reopen

• Bleeding that is not controlled with direct pressure

• Toe becomes cold, blue, numb, or tingly

• Pain get worse or isn’t well controlled by prescribed pain medicines

• You can’t put weight on your foot 

Should I Go to the Hospital for a Broken Toe?

If one of your toes hurts like hell and you have an inkling that you might have broken it, you may be frantically Googling things like, Should I go to the hospital for a broken toe? and then wondering, What does broken toe treatment even entail?

Well, broken toes are pretty common—and they’re also no joke, Dominic King, D. O., a staff physician and medical orthopaedic physician in the Department of Orthopaedic Surgery at the Cleveland Clinic, tells SELF.

So if you injured one of your toes and are wondering how serious it is and whether to seek care ASAP, you’re not being overdramatic. Here’s what you should know.

Yes, see somebody if you think you have a broken toe.

Most people break a toe by stubbing it or dropping something on it, according to the Mayo Clinic. If you did something like that and have broken toe symptoms like pain, swelling, and discoloration, per the Mayo Clinic—then you’ll definitely want to seek care. “Any time you think you may have broken a toe, even though it may seem like a very simple problem, you should be evaluated by a medical professional,” says Dr. King.

One of the first things the doctor may do is give you an X-ray to see what’s going on with the toe in question, Matt Bayes, M.D., sports medicine and regenerative orthopedic specialist at Bluetail Medical Group in Chesterfield, Missouri, tells SELF. They may also check for tenderness, injuries to the skin, blood flow, and nerve function to help diagnose the break, the Mayo Clinic explains.

It’s important to get your toe assessed because all broken toes are not alike. There’s actually a pretty wide range of severity when it comes to a broken toe, depending on factors like which toe you broke and the type of break, Gennady Kolodenker, a doctor of podiatric medicine and foot and ankle specialist with Hoag Orthopedic Institute in Irvine, California, tells SELF.

What can you expect from broken toe treatment?

The severity of your break affects the kind of broken toe treatment you need. Generally, treating a simple fracture—meaning that the parts of your bone are still lined up properly—involves immobilizing the toe so it can heal in one of a few ways.

Your doctor may put you in a walking boot for a few weeks, Dr. Bayes says. Or they may have you do what’s called “buddy taping,” where you tape the injured toe to your neighboring toe, which then acts like a splint, the Mayo Clinic explains. If you do this, Daniel Guss, M.D., M.B.A., a foot and ankle orthopaedic surgeon at Massachusetts General Hospital, recommends that you put a piece of gauze between your toes to keep them from rubbing together, and don’t tape them too tight. (And, as Dr. King points out, buddy taping a bad break could actually make things worse—another example of why it’s wise to see a doctor.) If it’s painful to wear a regular shoe, your doctor might provide you with a special stiff-bottomed shoe to protect the toe and make space for swelling, according to the U.S. National Library of Medicine.

While most breaks are not too serious, neglecting to correctly treat a badly broken toe in a timely manner can result in improper healing and issues down the road, Dr. Guss says. “If this is mismanaged, you could end up with a premature arthritic joint or an inability to walk normally,” Dr. Bayes adds. Here are a few signs and scenarios that require immediate attention and specialized medical treatment like going to urgent care or the ER (instead of, say, waiting to see your primary care physician the next day).

Big toe breaks

Breaking your big toe—which has a lot to do with your balance, strength, and gait—is a more complicated injury to treat, Dr. Kolodenker says. Big toe breaks may need a cast or a splint to heal, according to the U.S. National Library of Medicine. And although it’s not common, sometimes small pieces of the bone can break off and prevent proper healing, potentially requiring surgery, the U.S. National Library of Medicine explains.

Crooked toes

Other severe breaks are those that cause the toe to look crooked, according to the U.S. National Library of Medicine. If a toe break is displaced (i.e., your toe bone is pulled out of alignment) or angulated (it’s at a wrong angle), then it’s really important to get it fixed right away, Dr. King says. The doctor may have to manipulate the fragments of your toe bone back into the right position so that they fit snugly and heal properly, the Mayo Clinic explains, adding that they’ll numb your toe first. (Phew.)

Patient information about orthopedic disorders.

Feet
> Broken
Toe > Treatments

   Open
Reduction, Internal Fixation

Treatment Introduction

If your broken toe cannot be
positioned properly, you may be a candidate for surgery.
Surgery often can help patients with a condition called
“floppy toe.” A floppy toe has dislocated
in an awkward position after a fracture and is unstable
in the joint. You also may be a candidate for surgery
if your toe fractures in two or more fragments, or when
the fracture lines touch a joint in your toe. A fracture
in the joint itself has a high risk of dislocation.
Your surgeon can fix your broken toe in place with wires
that help hold your toe steady as it heals. v=PAT&doc_id=29″
target=”_new”>William G. Hamilton, M.D.,
team physician for the New York Knicks and New Jersey
Nets.

The actions you take before surgery
can be every bit as important as the procedure itself
in ensuring a healthy recovery.

   Prior
to your return home from the hospital, make sure that
you have received any equipment you will need when you
get home. This may include crutches or household items
to make movement around the house easier. You should
receive prescriptions for any of these from your doctor
before you go home from the hospital.

   Any
physical problems or changes in your overall health,
such as a fever or infection, should be reported to
your surgeon, and you should notify your surgeon of
any new medications you are taking.

   Understand
the potential risks and benefits of the surgery, and
ask your surgeon any questions that will help you better
understand the procedure. It can also help to talk to
someone else who has undergone the same surgery.

   Getting
a second opinion from another qualified surgeon is often
advisable, particularly in rare or unique cases.

   To
check if the orthopedist performing the surgery is board-certified
or eligible, call the American Board of Orthopaedic
Surgery at 919-929-7103.

v=PAT&doc_id=29″ target=”_new”>William
G. Hamilton, M.D., team physician for the New York Knicks
and New Jersey Nets.

At most medical centers, you will
go to “patient admissions” to check in for
your operation. There may be separate check-in areas
for ambulatory outpatient (patients who go home the
same day after surgery) and for overnight inpatient
surgery, so be sure to ask your doctor or an assistant
about this. After you have checked in to the hospital,
you will go to a holding area where the final preparations
are made. The mandatory paperwork is completed, and
your ankle area may be shaved, though this is not always
necessary. You will be asked to change into a hospital
gown and, if applicable, remove your watch, glasses,
dentures, and jewelry. You will have the opportunity
to speak with your orthopedic surgeon or an assistant
and meet the anesthesiologist or nurse anesthetist (a
nurse who has done graduate training to provide anesthesia
under the supervision of an anesthesiologist). Then,
you will walk or ride on a stretcher to the operating
room. Most patients are not sedated until they go into
the operating room. Here are some important steps to
remember for the day of your surgery:

   You
will probably be told not to eat or drink anything after
midnight on the night before your surgery. This will
reduce the risk of vomiting while you are under anesthesia.

   Arrange
for someone to drive you home when you are released.

   Wear
a loose pair of shorts, sweatpants, or other clothing
that will fit comfortably over your post-operative shoe
when you leave the hospital.

   Take
it easy. Keeping a good frame of mind can help ease
any nerves or anxiety about undergoing surgery. Distractions
such as reading, watching television, chatting with
visitors, or talking on the telephone can also help.

v=PAT&doc_id=29″ target=”_new”>William
G. Hamilton, M.D., team physician for the New York Knicks
and New Jersey Nets.

Open reduction and internal fixation
of your broken toe can take one to two hours to perform.
Regional anesthesia typically is injected into your
foot to numb your toe, and you usually are sedated so
you sleep through the procedure.

   An
incision usually is made along your toe, depending on
the specific location of the fracture.

   If
soft tissues are blocking your toe from returning to
its proper position, your surgeon may need to manipulate
your toe’s tendons or the joint capsule surrounding
your toe’s joint with your foot.

   Your
surgeon manually positions your toe where it joins your
foot.

   Your
surgeon then tests your toe’s motion. If it is
stable in the joint, your surgeon may repair the soft
tissues with sutures and close the incision.

   If
your toe cannot maintain its position, a strong, thin
wire, called a Kirschner wire, is then inserted so it
passes through your toe and your long foot bone. The
wire stabilizes your toe in the metatarsophalangeal
joint.

   Soft
tissues are repaired with sutures and your incision
is stitched closed.

   Your
foot is wrapped in compression dressing, which covers
your toe incision. Your broken toe is normally taped
to the healthy toe next to it.

   Your
foot is placed into an open-toe sandal that has a hard
bottom so your toes cannot bend and you are taken to
the recovery room.

v=PAT&doc_id=29″ target=”_new”>William
G. Hamilton, M.D., team physician for the New York Knicks
and New Jersey Nets.

Recovery Room

After surgery to stabilize your broken toe, you
will be transported to the recovery room where you will
be closely observed for one to two hours while the immediate
effects of anesthesia wear off. Your foot and ankle
will be elevated when you wake up. The post-surgery
shoe is open-toed and soft, bulky dressings cover your
incision and hide it from view. There usually is minimal
bleeding after surgery. After surgery, you usually experience
some pain and adequate pain medications will be prescribed
for you. You will be given intravenous (IV), oral, or
intramuscular pain medications as needed. You usually
can have visitors about a half-hour after surgery if
your physician feels you are in a stable condition.
Your temperature, blood pressure, and heartbeat will
be monitored by a nurse who, with the help of the doctor,
will determine when you are ready to leave the hospital.
Many patients can return home the same day after surgery.
Occasionally, you may be transported to the hospital
ward for further post-operative care, depending on the
amount of pain management you need. Before heading home,
your physician will give you instructions for wearing
the special post-surgery shoe. The shoe is an open-toe
sandal with a stiff, plastic sole that does not bend.
You will also meet a physical therapist who instructs
you in the use of crutches so you can keep weight off
your toe for about three weeks. Arrange for someone
to take you home from the hospital, as you will be unable
to drive a car. v=PAT&doc_id=29″ target=”_new”>William
G. Hamilton, M.D., team physician for the New York Knicks
and New Jersey Nets.

After open reduction and internal
fixation of your broken toe, you may need to be on crutches
for about three weeks. Rest as much as possible with
your foot elevated above the level of your heart. This
helps blood drain away from your toe and can control
swelling. Keep the bandage around your toe dry. Shower
with your foot wrapped in a plastic bag or bathe with
your injured leg outside the tub. There should be little
bleeding. Call your physician if you are bleeding through
the bandage. It is essential to keep weight off your
foot for the first few days. Everyone heals at a different
pace, so use your crutches as often as necessary to
avoid pain in your toe. You will rely less on the crutches
as pain decreases over the course of about three weeks.
Your physician also may prescribe pain medication to
help ease your pain during the first few weeks. Recovery
is easier when you have someone around the house who
can help with any physical chores. Wear the stiff-soled
shoe given to you in the hospital whenever you are moving
around. A typical recovery schedule after surgery for
a broken toe goes as follows:

   Three
weeks – Return to your physician’s office
for X-rays and removal of your sutures. The wires may
be removed from your toe, depending on the type of fracture
you suffered. Your physician may instruct you to “buddy
tape” your broken toe to the healthy toe next to
it. You will need to keep a dry gauze pad between your
taped toes.

   Three
to six weeks – Continue buddy taping your toe
and wearing the post-surgery shoe. Change the tape and
gauze as often as needed. When you apply the tape, your
broken toe should be securely attached to the healthy
toe but the tape should not be so tight that you lose
circulation. Position the gauze pad between your toes
so no skin is touching. If your skin moistens and rubs
against the other toe, it could become irritated.

   Six
weeks – Your physician will examine your toe again
and determine if you can begin bearing weight on your
foot with your toe taped. You may be able to begin walking
while wearing normal shoes that have a stiff sole and
extra room for your toes.

   Nine
to 12 weeks – Buddy taping may be discontinued.
You may be able to begin running again if your physician
determines that your toe has properly healed.

v=PAT&doc_id=29″ target=”_new”>William
G. Hamilton, M.D., team physician for the New York Knicks
and New Jersey Nets.

Rehabilitation

To maintain cardiovascular fitness while your incision
heals for about three weeks, upper body exercises performed
while sitting or lying down, or stationary cycling may
be recommended. You should begin range of motion exercises
for your toes, foot, and ankle about six weeks after
surgery. You may begin weight-bearing exercises with
short walks and increase the duration and intensity
as pain allows. When walking, wear the stiff-soled shoes
given to you at the hospital so your toe will not bend.
When your pain decreases, light jogging typically can
begin nine to twelve weeks after surgery. Most patients
can return to sports and activities about three months
after surgery. Wear a stiff-soled shoe when you begin
exercising. Experiment with different shoes until you
find the proper fit and support in a shoe so you can
exercise without pain. Athletes and people who want
to improve their recovery time may benefit from visiting
a physical therapist. A therapist can help you stretch
your toe to restore range of motion, and can teach you
specific toe exercises to strengthen the tendons and
muscles that stabilize your toe. For example, your therapist
may have you pick objects off the ground with your toes,
or draw the alphabet on the floor with your toes. The
final stage of physical therapy often involves proprioceptive
exercises to restore balance and coordination in your
foot. A BAPS board, made of a flat board balanced atop
a ball, commonly is used to increase your muscle control.
v=PAT&doc_id=29″ target=”_new”>William
G. Hamilton, M.D., team physician for the New York Knicks
and New Jersey Nets.

Once your broken toe has healed, you
typically can return to sports and activities without
any increased risk of reinjury. Some patients, however,
may have a decreased range of motion in their broken
toe after surgery. Avoid tight-fitting footwear during
activities. When playing contact sports, you may want
to wear shoes with a sturdy, roomy toe box. Be sure
to buy shoes that properly fit your foot and have extra
room in the toe. Take the usual precautions to avoid
direct contact with your toe. Do not carry objects that
are too heavy. If you have a tendency to stub your toe,
you may want to avoid walking barefoot in areas where
there is furniture or other objects. v=PAT&doc_id=29″
target=”_new”>William G. Hamilton, M.D.,
team physician for the New York Knicks and New Jersey
Nets.

How To Treat A Broken Pinky Toe

We’ve all done it. At some point in our life, we’ve misjudged a step and stubbed a toe against a piece of furniture. Oftentimes it happens to your big toe, and we’ talked about the difference between broken big toes and stubbed toes on this related blog. Your big toe is much more stable and strong than your other toes, so while you can break it by stubbing it, that’s usually not the case.

The same can’t be said for your other toes. Aside from your big toe, your pinky toe is probably the most common toe that gets stubbed or experiences trauma because it is on the end of your foot. Your pinky is more fragile that your big toe, so what happens if you catch your bare foot on the corner of your desk? Today, we explain how to care for broken pinky toes.

Treating Broken Pinky Toes

The good thing about treating broken pinky toes is that unless it’s an open fracture (where you can see the bone), you’re probably not going to need surgery. The vast majority of little toe fractures heal on their own with conservative care measures, but that doesn’t mean you can just grit your teeth and expect it to heal perfectly. But before we get into some treatment and care techniques, let’s take a look at some of the symptoms of a broken pinky toe:

• Sharp pain, especially when bearing weight
• Bruising
• Discoloration
• Swelling
• Warmer than other toes to the touch
• Disjointed appearance

If you’re dealing with the above symptoms, odds are you’re dealing with a broken pinky toe or at least a deep bruise. However, this typically isn’t a condition worth a trip to the doctor’s office. We love to help patients heal, but odds are we’re just going to tell you in person the same things that we’re telling you right here, so save yourself some time and money by just following these care guidelines.

The key to helping a broken pinky toe heal is to try and take as much weight off the toe as possible. Use crutches or a walking boot if they help, but some people prefer a more minimalistic approach, like by stuffing a cotton ball in their shoe to soften the force of each step. Also, since your toe may be swollen for a few days, opt for a looser fitting shoe to give it more room to breathe. When you’re not upright, try to keep the foot elevated.

Another thing you may find helpful is to buddy tape the injured toe to the adjacent toe. Again, consider sticking a small cotton ball underneath the toe before you tape them together, as this will act as a shock absorber while the adjacent toe will act like a splint to protect the pinky toe from injury. If pain is problematic, consider an over-the-counter pain reliever for the first couple of days. Odds are you’ll notice some improvements in the first 48 hours, but it’s not uncommon for pain to dull over the course of a couple of weeks.

If, however, pain worsens or you’re still dealing with pain after a month, set up a visit with a foot specialist. There’s a chance that a bone didn’t heal correctly, or something else is going on in your foot. Your doctor can have a look and provide a more case-specific treatment plan.

For more information about caring for broken toes, or to voice your concerns to Dr. Silverman, reach out to him in the contact box below.

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Related

90,000 Recovery after fractures and prolonged casting

Any injury, especially a limb fracture, is an extremely unpleasant event that occurs in a matter of seconds, but unsettles for a long time. Even if the bones after the removal of the plaster have healed correctly, a person’s torment often does not end there. Further, the patient will have a recovery period. Under the close supervision of the Artus clinic specialists, rehabilitation will be faster and more efficient.

Why do we need rehabilitation after fractures and plaster cast

Rehabilitation is an important step in the treatment of fractures.Only in exceptional cases does it happen that the function of the limbs is restored immediately. With prolonged immobilization of an arm or leg, the muscles atrophy, which leads to a decrease in joint mobility. Under the action of gypsum, trophic ligaments and joints, deterioration of blood flow are observed. In the first time after removing the plaster, patients often complain of the following manifestations:

• edema;
• pain at the site of injury to the limb;
• Difficulty in flexion and extension of the joints.

Most people who have suffered a bone fracture require restorative therapy, which consists of physiotherapy and exercise therapy.

Business moves faster in the hands of professionals

To develop the joints of the limbs, restoring their elasticity, will help: therapeutic massage, which helps to accelerate blood flow and lymph flow, pressolymphatic drainage, electrostatic massage, magnetotherapy, UVT, laser, exercise therapy and other methods. The professional actions of the doctors of the Artus clinic will help to restore the limbs to their former motor activity in record time.Even with a strong desire and following the recommendations of the attending physician, it will be difficult to carry out restorative procedures at home.

Only specialists in the field of orthopedics know what kind of load can be applied to the joint so as not to harm, they select the optimal methods for solving the problem based on the clinical case of each patient.

An individual approach is the key to successful rehabilitation

The duration and course of recovery after fractures largely depends on the condition of the patient’s muscles and ligaments. The type of procedures and the number of their sessions are determined by the specialists of the Artus clinic on an individual basis, depending on the age, general health of the patient, and the duration of limb immobility.

During rehabilitation after prolonged plastering, the orthopedist will help the patient to get rid of such unpleasant manifestations:

• reduction of edema;
• elimination of pain syndrome;
• stiffness of movements;
• muscle spasm;
• violation of blood flow.

In the Artus clinic, you can undergo effective rehabilitation after all types of fractures – shoulder, collarbone, fingers and toes, ankle. A particularly responsible approach to the recovery period is required after an injury to the leg and foot bones. Patients who come to the center note a positive result of the procedures under the guidance of professional doctors after the first session, as well as a significant reduction in the total time spent on rehabilitation.

90,000 Finger / hand tendon surgery

Tendon injury is a common problem, especially with open injuries.Closed injuries are less likely to involve tendons. In this case, even a minor injury to the finger can lead to injury to the tendons, since they are located very close to the skin.

Types of tendon injuries in the hand area

Injuries can be:

• Concerning the extensors and flexors of the fingers.
• Open and closed.
• As a result of blows or unsuccessful movements.
• With complete or partial tearing of tissues.

Making a diagnosis

In the presence of open wounds, diagnosis is not difficult. The nature and extent of damage can be determined by visual inspection. If the tendons are torn, their ends can be seen with the naked eye. With closed injuries, the diagnosis is somewhat complicated and requires the use of additional methods. Basically, ultrasound diagnostics are used to confirm the diagnosis.

The main signs of a ruptured tendon are:

• Inability to bend the injured finger, lack of motor activity.
• Deep wound in the palm or wrist.

It is impossible to heal the tendons without surgery; it is necessary to restore the flexor tendons of the fingers of the hand. This is because the muscles will contract, thereby preventing the tendon from constantly touching.

Operation on the tendons of the hand or finger is performed in the following cases:

• Open trauma.
• Tendon rupture (open or subcutaneous).
• Presence of old damage.

Thanks to the possibilities of modern surgery, the restoration of the tendons of the hand can be carried out practically without restrictions, even for pregnant women and small children.

How is the restoration going

It is better to start measures to restore tissue immediately, in the first few days after injury. Rebuilding a toe after a tendon rupture requires expert assistance using microsurgery techniques. Thanks to the use of an operating microscope and high-precision methods, the following is achieved during the operation:

• Minimal invasiveness of the intervention.
• Minimal risk of complications.
• Possibility of restoring the damaged nerve.
• Achievement of optimal fixation, reliable tissue connection.

The timing of the surgery is very important. The sooner after damage it is carried out, the greater the likelihood of complete recovery.Otherwise, degenerative changes develop, overcoming which will require more serious intervention and plastic surgery of the hand.

If the tendon comes off the bone, it is fixed in place and sutured. After the limb is subject to mandatory immobilization, so that the tissues have the opportunity to grow together in the correct position. Usually a splint is used for this. If the rupture is incomplete, fixation of the limb without surgery may be effective.The main condition is a sufficient tension of the tendon in a fixed state.

Postoperative recovery period

Rehabilitation includes several points:

• Exclusion of movement of the affected area (a plaster cast is used for this).
• Physiotherapy course.
• Therapeutic exercises with a gradual increase in load.

Exercise is necessary to normalize blood circulation in the hand, tone the muscles, develop hand movements, and restore motor skills.Only if all points of the recovery plan are observed, mobility and all functions can be restored completely.

The operation can be performed in the modern clinics of the Central Clinical Hospital of the Russian Academy of Sciences in Moscow. Appointments and any required information are available by phone or on the clinic’s website.

Therapeutic diet after a bone fracture

After a fracture, any bone needs to be restored. A healthy, balanced diet rich in essential nutrients can help speed this up.

You should not take dietary supplements (bio supplements), especially if your doctor does not recommend. They don’t always work well. It is much better to get the necessary nutrition for the body from regular food.

Protein

Protein makes up approximately half of the structure of the bone. When a person has a fracture, the body really needs it to build new bone and the bones heal faster. Protein also helps the body take in and use calcium, another key nutrient for healthy bones.

Excellent sources of vegetable protein: nuts, beans, avocados, spinach, cauliflower, cabbage, broccoli, soy products and fortified cereals.

Sources of animal protein: meat, fish, gelatin, milk, cheese, cottage cheese, yogurt, sour cream.

Calcium

This mineral also helps build strong bones, so foods and drinks rich in it can help heal bone fractures as well as prevent diseases such as osteoporosis and diabetes.Adults should get 1,000 to 1,200 milligrams of calcium every day.

Products containing calcium: eggshells, milk, cottage cheese, cheese, yogurt, broccoli, turnips, cabbage, soybeans, beans, sesame seeds, almonds, green parsley, garlic, hazelnuts.

Vitamin D

This vitamin should be part of your diet to help you heal. Vitamin D helps the blood to take in and use calcium and store minerals in the bones.

A person gets vitamin D when sunlight hits the skin, so you should spend a small amount of time outdoors every day – 15 minutes may be enough for someone with exposed skin.

Vitamin D is found naturally in only a few foods, such as egg yolks and fatty fish, but manufacturers can add it to other foods, such as orange juice. The older a person is, the more vitamin D they need.

Products containing vitamin D : fish (especially salmon), cod liver oil, sardines, liver, peas, egg yolks, red caviar, mushrooms, milk, cheese.

What vitamin D deficiency can lead to:

• dental caries
• flu
• asthma
• type 2 diabetes
• hypertension
• rheumatoid arthritis
• bowel disease
• cancer

7

9000 Vitamin C

Collagen is a protein that is an essential building block for bone. Vitamin C helps the body make collagen, which helps bone heal. Vitamin C is found in many delicious, fresh fruits and vegetables. Processed foods can lose some of their vitamin C and should be eaten fresh or frozen.

Sources of vitamin C: oranges, kiwi, various berries (currants, strawberries), tomatoes, peppers, potatoes and green vegetables.

Iron

Iron deficiency anemia is when a person does not have enough healthy red blood cells, therefore, recovery from a fracture is slower.Iron helps the body make collagen for bone repair. It also plays a role in getting oxygen to the bones to help them repair.

Sources of iron: red meat (beef, nutria, turkey), fatty fish, eggs, dried fruits, leafy green vegetables, whole grain breads and fortified cereals.

Potassium

Potassium in the body is necessary in order not to lose a lot of calcium during urination. Eat plenty of fresh fruits that are rich in potassium.

Sources of potassium: bananas, orange juice, potatoes, walnuts, pine nuts, hazelnuts, dried apricots, mushrooms, spinach, soybeans, lentils, peanuts, beans, raisins, fish, meat, milk.

What not to eat and drink in case of fractures?

Salt: Too much salt in the diet can lead to calcium loss during urination.

Alcohol: alcoholic beverages are contraindicated as they slow down bone healing. Also, drinking alcohol can make a person unstable on their legs, which can lead to a fall and the risk of injury to the same bone.

Coffee : A lot of caffeine – more than four cups of strong coffee a day – can slow bone healing a little. However, a small amount of coffee or tea will not harm the body.

For your bones to heal faster, nutrition should be varied!

Read all about hip fracture here.

Fractures of the fifth metatarsal bone

Today I would like to tell you about the unique experience of treating one of the most unpleasant problems faced by football players and doctors – fractures of the fifth metatarsal bone.

Their treatment is very complex and these injuries often recur (as, for example, in Neymar and Manuel Neuer).

I wrote with colleagues from FC Zenit Vladimir Khaitin and FC Lokomotiv Gleb Chernov a small material on this topic with relevant links that must be taken into account by doctors and coaches in physical training and rehabilitation, so as not to further multiply myths and legends deep antiquity))

“Our experience in treating fifth metatarsal fractures in professional football players using platelet-rich plasma”

Injuries to the metatarsal bones in football are relatively rare and in most cases are localized in the fifth metatarsal bone.

The main method for diagnosing fractures of this localization can be called X-ray, which in most cases allows you to verify the diagnosis.

Treatment tactics depend on the location of the fracture according to the classification of Lawrence and Botte’s, according to which there are three zones of their localization.

Fractures located in zones 2-3 are at high risk for delayed consolidation and non-union, and therefore in athletes they are most often treated with osteosynthesis using intramedular screws.

The average recovery time with this type of treatment is at least 8 weeks.

This report describes five cases of fractures of the fifth metatarsal bone, located in zones 2-3 in professional football players, who were treated with an immobilization boot, cryotherapy, calcium and vitamin D supplements and local injections of platelet-rich plasma, which contains multiple factors growth.

The period of return to regular training activity was 43-50 days, and no recurrence of damage was found within 6 months of follow-up.

Introduction

Treatment of fractures of the fifth metatarsal bone among athletes is an urgent problem due to the long duration of treatment (8 weeks or more) and a large number of relapses [1].

In football, they account for 0. 5% of all injuries sustained by elite European footballers with an average treatment period of about 80 days, regardless of the type of treatment chosen [2]

This type of fracture is one of the few diagnostics based on radiography, which in most cases allows to verify the diagnosis.

This type of fracture is one of the few diagnoses that are based on X-ray, which in most cases allows the diagnosis to be verified.

In the population of athletes, the tactics of treating such injuries depends on their localization according to the Lawrence and Botte’s classification, in which there are three zones [3].

Fractures of the first zone are most often treated conservatively with good functional results in any of the population categories.

Fractures of the second and third zones with conservative treatment have a tendency of delayed consolidation and non-union, therefore the most common method of their treatment, especially in the population of athletes, is osteosynthesis using intramedullary screws [4].

Development of new methods of conservative treatment of such fractures with minimal treatment time and the number of relapses is an urgent task for modern professional football.

One of such techniques can be the use of PPP, which contains numerous growth factors.

BTP is actively used in the treatment of acute and chronic injuries of the musculoskeletal system, in particular, muscle injuries, tendinopathies and arthrosis with positive results [5,6].

Experiments on animals have shown a beneficial effect of PTP on the healing of both traumatic and osteorotic fractures [7,8].

However, we could not find data on the use of PPP in the treatment of metatarsal fractures.

Description of cases

The results of treatment of fractures of the fifth metatarsal bone in five young football players are presented.

The players were 19-21 years old, 178 cm tall, and weighed 71-75 kg.

All injuries occurred between November 2016 and June 2018 during matches during the competition season. In all cases, the game was played on an artificial turf.

Before the moment of injury, there was no discomfort or pain in the area of ​​the fifth metatarsal bone.

The mechanism of injury in three cases was contact, in two non-contact – during running with acceleration, a sharp local pain appeared in the projection of the fifth metatarsal bone.

All footballers immediately stopped their sports activities and were immobilized with an orthosis.

In all cases, the performed radiography confirmed the diagnosis (Figure 1).

In the first three days, the initial therapy was carried out according to the POLICE protocol, which included the use of cyclic compression therapy (7-8 times a day for 20 minutes), wearing compression hosiery, as well as an immobilization orthosis mediROM Walker.

Nonsteroidal anti-inflammatory drugs were not used in any case.

From the first day of treatment, calcium began to be used at a dose of 1000 mg per day and vitamin D at a dose of 5000 IU for 60 days.

The first injection of platelet-rich plasma (4-5 ml) was performed 3 days after the injury.

Three such injections were performed with an interval of 7-10 days.

From the 3rd day after the first injection of PPP, low-intensity training on a bicycle ergometer began at 30-40

From the 7th day of treatment, rehabilitation training began, aimed at improving blood circulation with the use of exercises without axial load on the foot.

In all cases, 5-7 days after the second injection of PTP, the pain syndrome during normal walking stopped, but the use of the orthosis continued for 30 days from the moment of injury.

Three days after the disappearance of the pain syndrome, low-intensity running work (10-15 minutes) began with subsequent progression.

From the 30th day, all the players started to work individually with the ball in boots.

The time to return to regular training activity varied in the range of 43-50 days.

Control X-ray was taken 3-5 days before the start of RTD.

There were no allergic reactions or other side reactions during treatment.

Discussion

Fractures of 2-3 zones of the fifth metatarsal bone are at high risk for delayed consolidation and non-union.

The data available to date on conservative treatment report a long return to RTD and a large number of relapses.

Thus, Japjec et al. the average duration of treatment for most fractures of 2-3 zones after osteosynthesis was 8 weeks, and with conservative treatment, even after 6 months, more than half of the patients had no signs of consolidation and remained painful [9].

In this regard, in most cases, in the group of professional athletes, surgical treatment is currently considered the method of choice in the treatment of such fractures.

Hunt KJ, et al.reported on 21 operated athletes with an average recovery time of 12.3 weeks using osteosynthesis using intramedular screws and only one re-fracture.

O’Malley et al. Reviewed the results of surgical treatment of 10 NBA basketball players with a median recovery time of 9.8 weeks. At the same time, repeated fractures occurred in three cases [10].

Thus, the currently available data show that even surgical treatment of fractures of 2-3 zones of the fifth metatarsal bone is characterized by a long rehabilitation period and frequent recurrent fractures.

In this regard, the data obtained by us on the conservative treatment of such injuries using local injections of PPP may be of interest for further research.

References

1. Chi Nok Cheung1 and Tun Hing Lui1, *. Proximal Fifth Metatarsal Fractures: Anatomy, Classification, Treatment and Complications Arch Trauma Res. 2016 Dec; 5 (4): e33298. Published online 2016 Jun 13. doi: 10.5812 / atr.33298

2.Ekstrand J1, van Dijk CN. Fifth metatarsal fractures among male professional footballers: a potential career-ending disease. Br J Sports Med. 2013 Aug; 47 (12): 754-8. doi: 10.1136 / bjsports-2012-092096. Epub 2013 Apr 9.

3. Lawrence SJ1, Botte MJ. Jones’ fractures and related fractures of the proximal fifth metatarsal. Foot Ankle. 1993 Jul-Aug; 14 (6): 358-65.

4. Hunt KJ1, Anderson RB. Treatment of Jones fracture nonunions and refractures in the elite athlete: outcomes of intramedullary screw fixation with bone grafting.Am J Sports Med. 2011 Sep; 39 (9): 1948-54. doi: 10.1177 / 0363546511408868. Epub 2011 Jun 1.

5. Grambart ST1. Sports medicine and platelet-rich plasma: nonsurgical therapy. Clin Podiatr Med Surg. 2015 Jan; 32 (1): 99-107. doi: 10.1016 / j.cpm.2014.09.006.

6. Laudy AB1, Bakker EW2, Rekers M3, Moen Mh5. Efficacy of platelet-rich plasma injections in osteoarthritis of the knee: a systematic review and meta-analysis. Br J Sports Med. 2015 May; 49 (10): 657-72. doi: 10.1136 / bjsports-2014-094036. Epub 2014 Nov 21.

7. Simman R1, Hoffmann A, Bohinc RJ, Peterson WC, Russ AJ. Role of platelet-rich plasma in acceleration of bone fracture healing. Ann Plast Surg. 2008 Sep; 61 (3): 337-44. doi: 10.1097 / SAP.0b013e318157a185.

8. Chen L1, Yang X, Huang G, Song D, Ye XS, Xu H, Li W. Platelet-rich plasma promotes healing of osteoporotic fractures. Orthopedics. 2013 Jun; 36 (6): e687-94. doi: 10.3928 / 01477447-20130523-10.

9.Japjec M1, Starešinić M2, Starjački M2, Žgaljardić I3, Štivičić J2, Šebečić B2. Treatment of proximal fifth metatarsal bone fractures in athletes. Injury. 2015 Nov; 46 Suppl 6: S134-6. doi: 10.1016 / j.injury.2015.10.052. Epub 2015 Nov 10.

10. O’Malley M1, DeSandis B2, Allen A1, Levitsky M1, O’Malley Q1, Williams R1. Operative Treatment of Fifth Metatarsal Jones Fractures (Zones II and III) in the NBA. Foot Ankle Int. 2016 May; 37 (5): 488-500. doi: 10.1177 / 1071100715625290. Epub 2016 Jan 18.

risk factors, clinical presentation, principles of treatment and possible complications

In this article, we will acquaint you with the types, manifestations, methods of first aid, diagnosis and treatment of fractures of the toes. This information will be useful for you, and you will be able to suspect the presence of such an injury in time, correctly provide first aid to the victim and make an adequate decision on the need for treatment by a specialist.

Classification of fractures of the toe

Closed fractures are the most common.In this case, the integrity of the skin is preserved. Compression injury is often accompanied by displacement. An open comminuted fracture is difficult to repair. But much is determined by the location of the damage. In this regard, allocate:

• fracture of the big toe of the leg – often accompanied by a fracture of the sesamoid bone. Intra-articular lesions most difficult to treat,
• fracture of the index finger – means damage to one or more phalanges of the fingers,
• fracture of the middle finger – the nail phalanx suffers more often, and along the fracture line the fracture can be oblique, longitudinal or transverse,
• Fracture of the ring finger – a single injury is rare, very often the damage also affects the little finger.There are also simultaneous injuries to the 1,2 and 4,5 fingers,
• fracture of the little toe – One of the most common injuries is a fracture of the proximal phalanx.

Damage without displacement heals faster, and medical reduction is not required. It is much harder in case of significant deformations. At the same time, there are several types of displacements:

• with divergence and overstepping,
• lateral and angular offset,
• with wedging of fragments.

In case of damage to the middle and distal phalanxes, the treatment tactics will be the same, although the damage itself occurs in different ways. Only a punctured fracture of the toes can cause a fracture of the middle phalanx. It is quite difficult to damage it if dropped or hit.

Fractures of the phalanges

Swelling occurs at the site of injury. A blow to the big toe causes similar disturbances as with a thumb injury, due to the presence of only two phalanges.Phalangeal fractures are divided into T-shaped, oblique and transverse. A direct impact on the fifth toe causes multiple injuries due to the small size of the phalanges. The affected little finger instantly swells and becomes cyanotic.

ICD trauma code 10

Code S92 covers all foot fractures. With an injury such as a broken little finger, a separate code is not assigned, but with a thumb injury, the code S92 is prescribed in the card. 4. In case of a complex fracture with multiple injuries of the foot, the disease is designated by the code S92.7. All fractures of any toe other than the thumb are covered by code S92.5.

Reasons

Injuries caused by bone pathologies occur only in 5% of cases from general fractures. As a result of this injury, the integrity of the group of bones is disrupted, and recovery is extremely difficult. So, if the phalanx of the little finger is damaged, cracks in the metatarsus are often observed. A minor blow to another object can cause such pathologies. It is enough to step on a person’s foot to provoke injury.

Symptoms

What are the first signs of a toe fracture? First of all, it is intense pain. It increases with tapping or palpation. Painful shock does not occur. Even in the event of a serious injury, the pain can be tolerated.

Hematoma in the area of ​​the fracture indicates a rupture of blood vessels. In some cases, the leg becomes literally purple. Puffiness after a fracture often occurs with severe bruising and damage to soft tissues.

If there are wounds, then we are talking about an open injury.Skin lesions often accompany symptoms of a fractured or cracked big toe. Other signs of a toe fracture are:

• redness and local hyperthermia,
• enlargement of the damaged finger in size,
• restriction of mobility or complete immobilization.

Symptoms of a toe fracture may include shortening of the injured toe and its abnormal mobility. In case of bone crushing, the fragments can be seen with the naked eye.Signs of a broken little toe include a deformity of the foot and a possible deeper shift of the fifth toe. The characteristic symptoms of a fracture of the little toe include crepitus of bones or bone fragments.

First aid

In this case, the procedure will be as follows:

• Give the patient an anesthetic,
• treat the wound, if any,
• fix the damaged pin.

If the pain syndrome does not decrease, then non-narcotic analgesics are offered.Immobilization should be done if displacement is suspected. You can fix your toe with a bandage and splint.

Usually the thumb is immobilized. It is wrapped with a pencil or other solid and suitable object. Fixation is not always justified.

Most often, the patient is simply laid down or seated, and the leg is placed on a dais.

If the main phalanx of 4 fingers is damaged, then you can fix the finger with the adjacent one. It is impossible to tie the phalanges tightly, a cotton pad is placed between them.

Cold will help relieve pain and swelling. A bag of crushed ice is applied for 5-10 minutes, and then a break is taken to avoid frostbite.

Cooling will help if there is a fracture of the little toe, but for this damage, first aid will be slightly different.

What to do if the little toe is broken

In case of injury to the little toe, the leg must be lifted up and placed on a pillow in a relaxed position. This will prevent swelling and swelling of the soft tissues.Little finger immobilization is not required, but the foot must be secured to bring the victim to the hospital. Shoes are not worn, otherwise the chipped bones may be displaced.

What else to do in case of a broken toe at home? After carrying out anesthetic and anti-inflammatory therapy, it remains only to call an ambulance. Without an accurate diagnosis, it is difficult to take further action. It is forbidden to adjust your finger yourself.

Diagnostics

If the second and further fingers are damaged, the patient may not be aware of the fracture.Often the symptoms are similar to a common bruise. How to identify a fractured toe without X-ray?

An experienced physician will be able to understand the nature of damage during palpation and tapping. However, it is not always possible to recognize complex wounds visually. You can find out the crack using CT. But this method looks redundant and unjustified when the damage is obvious.

Treatment

If the broken little fingers on the leg are displaced, then they are set. How to treat a fracture in the event of a closed injury? The method of one-step reduction is usually used.

Treatment of a toe fracture begins with anesthesia, after which the toe is gradually extended, returning it to its physiological position. After the adjustment, the functionality of all fingers is checked. If the swelling goes away and the fingers are functioning properly, install the retainer. This is usually a cast, but there may be a bandage.

The timing of immobilization of the phalanges of the toes is determined by the severity of the injury. For minor injuries, a thumb brace can reduce stress and protect the foot from external influences.

If the fracture cannot be cured with a one-stage closed reduction, skeletal traction is used. It is an invasive repair method that keeps the bone fragments in the correct position.

The damaged little finger (or other finger) is pierced and a nylon thread is inserted. If the little toe is broken, you can fix it with special pins. In adults, fusion takes several weeks; in children, it takes less.

The puncture site is treated with antiseptics, and after removing the retainer, orthosis is installed on the finger.

It makes no sense to use folk remedies for fracture. The exception is phytopreparations with decongestant, anti-inflammatory and analgesic effects. But they are used for short-term treatment. Products with gelatin content – jelly and jellied meat allow to speed up the process of accretion.

Surgical treatment

Despite the surgical precision in open surgery, there are many difficulties that arise from the specifics of the therapy.The risk of infection and suppuration remains high, and it may be difficult to administer anesthesia.

How much to treat and wear plaster

How to quickly heal a damaged foot and shorten the duration of fracture treatment? Much is determined by the individual characteristics of the patient’s body and the specifics of the injuries themselves. After open reduction, the bones grow together for a long time. Whether a plaster cast is needed after the main treatment is determined by the traumatologist. But no reduction is complete without additional commit.

You will have to wear a cast as long as a finger fracture heals. With cracks and minor fractures of the toes, immobilization lasts up to 3 weeks.

In case of displacement, you can walk no earlier than after 4 weeks, and sometimes after 6 weeks. How much a finger fracture heals in the case of an open wound depends on the complexity of the operation. Plaster is usually prescribed for a period of 5-6 weeks.

Disability recovery takes up to 2 months if complications have occurred.

In the event of an incorrect splice, a second operation will be required. It’s hard to say how long the recovery will take. Usually the period of incapacity for work is doubled.

Rehabilitation

The patient is recommended to start exercise therapy immediately after removing the plaster. One effective exercise is fingering small objects with your toes. Such gymnastics will be especially useful if nerves have been damaged due to injury. Overvoltage during training should not be.First, they train for 15-20 minutes, over time, the duration of the classes is increased to 40-60 minutes.

Physiotherapy

Exercises after a toe fracture involve squeezing and straightening all toes. The injured finger is not used for some time, but then it is also connected to gymnastics.

At the first stage, it is better to replace the exercises with self-massage. Light stroking and squeezing will improve blood flow and prevent atrophy. There should be no unpleasant sensations during gymnastics.

Duration of therapy – no more than 10 minutes, course duration – 10-15 procedures.

You can develop a foot on your own, but before doing massage and gymnastics, you should consult a doctor. If the fracture of the toe heals slowly, then hardware physiotherapy is prescribed. The following treatments have proven effective:

• UHF-therapy – reduces pain syndrome, improves tissue trophism, stimulates metabolism and capillary blood circulation.One of the most reliable methods of recovery after fractures,
• magnetotherapy – accelerates regeneration, prevents the development of diseases of the skeletal system, reduces edema,
• interference currents – activate trophic processes, relieve hematomas, normalize blood circulation.

Ozokerite applications have useful properties. They dilate blood vessels and eliminate pain after a long stay in one position. Salt baths have a similar effect.Baking soda baths will prevent complications and the development of callus. They eliminate local inflammatory reactions and reduce post-traumatic edema.

Complications and consequences

Negative consequences arise from the lack of treatment. Many patients simply do not go to the doctor, because the injury does not bother them much. But this is at first. Over time, the deformities become irreversible, and the foot does not function properly.

Complications can arise from errors in therapy. If a fracture of the phalanx of one of the toes does not heal properly, a callus may form. This is an abnormal tissue at the fusion site. Its size sometimes exceeds the size of the phalanx.

The growth of replacement tissue is due to the weakness of the bone structure. Callus compensates for the lack of strength, but it causes great inconvenience to the patient. It causes pain, interferes with walking, complicates the selection of shoes.

In addition, it is always an additional source of inflammation and a vulnerable spot in the event of injury.

If the callus is formed due to improper reduction, then a second operation is required. In this case, healing will take longer than usual. In the presence of a bone defect, repeated surgery is associated with the risk of tissue inflammation.

Other complications of toe fractures are also distinguished:

• False joint – occurs due to shrapnel damage. The scattered fragments are erased and become separate elements of the bone. They are not connected with each other, and the space between them is the same false joint.Due to the absence of cartilage tissue, an inflammatory process occurs between the fragments. The functionality of the toe and foot is generally reduced. If the upper phalanx is damaged, then nail ingrowth is possible,
• ankylosis – occurs due to inflammation in damaged tissues. Over time, the joints become ossified and lose their mobility. This is one of the reasons why toes go numb. Sometimes they are completely immobilized, which leads to tissue death. To get rid of this defect, prosthetics are used,
• Osteomyelitis is one of the most dangerous complications.It occurs as a result of improper treatment of an open fracture. Pathogenic microorganisms enter the bone and cause inflammation. The infection enters the body through an open wound. Less commonly – by hematogenous route. Correct initial treatment of damage will prevent the development of osteomyelitis. If it is not possible to avoid infection, powerful antibiotic therapy is used. In advanced cases – depressurization of the bone,
• shortening of the bone – is the result of improper fusion. Incorrect reduction followed by immobilization firmly fix the fragments in the wrong position.The supporting function of the bone decreases, pain occurs when moving. The risk of re-fracture increases dramatically. The next reduction will help to correct the situation, but the fragility of the damaged bone is still preserved.

Prevention

In case of a weakening of the skeletal system, calcium supplements are prescribed. They are recommended for prophylaxis for all elderly people, women during and after menopause, as well as pregnant and lactating women.

From a medical point of view, the best prevention is increased caution on the street and at home.Avoiding a fracture of the main phalanx is easy if you look under your feet and prevent injury.

Products enriched with calcium, magnesium, vitamin D will help to strengthen bones. This group includes fermented milk products, egg yolks, nuts, chicken liver, seafood, olive oil. They also prevent diseases such as arthritis and arthrosis. At the same time, you should limit the intake of oxalic and uric acids.

Source: https: //xn--h2aeegmc7b.xn--p1ai/pervaya-pomoshh/perelomyi/perelom-paltsa-na-noge

3 symptoms (signs) of a broken toe – how to understand that it is broken

Fracture of a toe is one of the many and especially widespread types of injuries sustained by a person in everyday life.

To obtain such a serious mechanical damage to the bone tissue, it is enough to apply insignificant efforts. A bruise, an unsuccessful jump, a fall on the leg of even a small object, as well as many other reasons can lead to a fracture.

It should be emphasized that for persons suffering from various forms of diseases leading to pathological fragility of bones, it is rather unfortunate enough to distribute the weight of their own body on the toes.

An important point is the provision of timely assistance to the victim.

The absence of such can lead to serious consequences, including loss of flexibility and mobility of the fingers, constant pain, and in severe cases – tissue necrosis.

Classification

The term “fracture” refers to the violation of the integrity of the bone tissue, namely the phalanges of the toes, due to the application of an action, the force of which is many times greater than the resistance of the damaged segment. In direct proportion to the nature and type of the injury received, there are several options for classifying fractures of the toes.

Mainly, injuries to the toes are divided into closed and open. In the latter case, a kind of application to the resulting injury is a violation of the integrity of the skin, which arose as a result of the displacement of bone fragments.

For fractures with displacement of individual fragments of bone fragments, this type of injury is subdivided into splinter-free, one or two-splintered, and multi-splinter. As the name suggests, the determining factor is the presence and total number of chipped segments of the damaged phalanx of the toes.

In addition, bone fractures are classified accordingly with an injured phalanx. In this case, damage to the big toe is isolated as a separate subspecies, which is due to some difference in its anatomical structure, which consists in the presence of only two phalanges.

Reasons

As mentioned above, numerous factors can cause a leg fracture, including unsuccessful falls, bruises, improper distribution of the load on the toes, as well as other factors of a similar nature.However, regardless of the reason that provoked the injury, it is recommended that everyone know what to do in case of a toe fracture and how to provide first aid to the victim.

Symptoms

Symptoms and signs of a toe fracture may vary somewhat in direct proportion to the nature of the injury. At the same time, the first manifestations of the fracture are especially acute, some time after receiving mechanical damage, the clinical picture becomes somewhat blurred. The general symptomatology is as follows:

• The predominant signs of a violation of the integrity of the bone tissues of the toes are pain and sensations of pulsation in the area of ​​the injured area. At the same time, depending on the nature of the injury, painful sensations can spread to the entire leg or be localized in the immediate vicinity of the damaged phalanx.
• The appearance of tissue edema or bruising, which are the result of damage not only to bone segments, but also to the skin or blood vessels.
• In displaced fractures, the deformity of the injured toe can also be seen with the naked eye. In this case, with open forms of mechanical damage, open wound surfaces may appear.

Unlike other types of injuries, such as bruises, symptoms of a broken toe do not fade even after several hours. Moreover, painful sensations can persist for a long period of time, even if the patient is provided with medical assistance.

First aid

In order to provide first aid to the victim, you need to know how to determine if a toe is broken. First of all, long-term pain that does not go away speaks of receiving this injury. In addition, the spread of pain to the entire foot may indicate a fracture. If there is a suspicion of a fracture, it is necessary: ​​

• First aid for a fractured toe is to numb the affected area.This can be done with drugs for local or internal use.
• Next, you should immobilize or, simply put, fix the damaged segment using any homemade splint and sterile bandage. If there are open wound surfaces, the wound should be disinfected.

And, of course, an urgent measure of help is contacting a medical institution.

Diagnostics

When an injury is received, the question of how to determine a fracture of a toe becomes relevant.The determining factor in this case is long-term pain syndrome. However, trying to diagnose at home is still not worth it. To determine a fracture, you should definitely consult a doctor.

Among the many diagnostic methods, radiography is especially often used to detect the presence of damage. In severe cases, for example, against the background of numerous fragments, it is possible to use computed tomography. This study allows you to get more detailed pictures of the injured toe.

Treatment

The process of treating broken toes is similar to that used for injuries to the arms, legs or any other elements of the bone skeleton. To determine the most suitable option for conservative therapy, it is required to carry out diagnostic procedures, the main purpose of which is to determine the type, severity of the injury received.

Emergency care

If your little finger or any other finger is broken, you should not ask yourself questions about what to do, it is important to seek help from a medical facility as soon as possible. Before the arrival of the ambulance, you can give the patient any pain medication.

Urgent care primarily consists in the use of anesthetic drugs that will help relieve intense pain. Further, after carrying out diagnostic measures, it is necessary to immobilize the injured finger, the essence of which is to apply a plaster cast, fixing the broken finger in the anatomically correct position.

A few days after the application of the splint, the patient needs to visit a specialist again for a second study, which will reveal the dynamics of bone tissue healing, the presence or absence of complications, and assess the process of bone fusion as a whole.If the bone is properly healed, the immobilizing dressings are removed four to eight weeks after injury.

Fracture of the thumb and middle finger

Fractures of the big or middle toe occupy a separate place in the general list of injuries. This is due to intense painful sensations, the appearance of which is characterized by such damage.

The treatment tactics used in this case does not differ significantly from the methods used for other types of fractures. The only thing that should be paid attention to is the timely provision of assistance to the patient, which consists in the introduction of anesthetic drugs.

The absence of such against the background of a low pain threshold can lead to the development of a shock state in the patient.

Multiple fracture

On the background of multiple fractures of the toes, it is possible to apply a general fixation bandage on the entire surface of the injured leg. This measure allows you to exclude possible displacement of bone fragments and prevent possible complications. This is the most common approach for fractures of the little finger and ring fingers.

A separate point is in this case the nature of the injuries received. In the event that the extreme phalanges of the toes were subject to damage, the application of an elastic patch is sufficient to fix them, which reliably holds the fingers in the anatomically correct position even when the thumb moves.

Compound fracture with displacement

For complex fractures associated with displacement of bone segments or the formation of several fragments, an invasive method of treatment is used. There are two options for surgical intervention, each of which is used only according to the doctor’s prescription:

• Metal plate. The essence of this procedure is as follows: during surgical manipulations, individual bone segments of the injured toe are tightly attached to a thin metal plate, which is a kind of frame. A foreign object is removed only after complete healing of bone tissue and the formation of a callus.
• Metal spoke. This method is classified as sparing, since the removal of the wire is not painful and does not require the use of general anesthesia. This procedure involves drilling individual fragments of the damaged leg bone, followed by stringing them onto a thin metal knitting needle. After the damaged tissue is restored, the fixing object is simply pulled out and removed.

Open fracture

Due to the absence of large blood vessels, even open forms of finger fractures are not potentially hazardous to the health and life of the victim. However, due to the formation of an open wound surface, treatment is still required.

Initially, the wound is treated with a disinfectant antibacterial preparation. Further, bone fragments of the damaged phalanx of the finger are fixed in the anatomically correct position. Metal needles or plates can be used for this procedure.

After this procedure, sutures or a sterile bandage are applied to fix the damaged skin.The length of the recovery period can vary significantly depending on the severity of the injury.

Recovery period

After removing any fixing bandage, including plaster, the patient needs a certain time to restore the functional features of the injured leg.

The need for rehabilitation is due to the fact that when the injured limb is in an immobilizing bandage, muscle tissue loses its elasticity and becomes less mobile.

To develop muscles and strengthen bone tissues, patients are recommended such methods of treatment as physiotherapy exercises, massage, physiotherapy methods, adherence to a diet with a high content of vitamins, microelements, moderate physical activity.

Application of these techniques on a regular basis will allow to normalize, stabilize the condition of the affected finger and limb, prevent possible complications, and quickly return to the previous full life.

Source: https://SkeletOpora.ru/travmy-kolenej/perelom-paltsa-na-noge

Signs of a toe fracture, treatment

Fractures of toes are common in the practice of traumatologists and no one is immune from their occurrence. You can get such an injury even with a banal blow of your leg against a corner, furniture, or when you twist your leg.

In 95% of cases, the toes break due to traumatic causes – impact or compression.However, sometimes such injuries occur due to pathological factors – osteoporosis, osteomyelitis, neoplasms or bone tuberculosis. These diseases cause destruction of the bone, and even a minimal mechanical effect on it can cause its fracture.

According to statistics, fractures of the toes account for 5% of all fractures, and in case of leg injuries, every third patient of a traumatologist is diagnosed.

As a rule, they respond well to treatment and there is a misconception among the population that such fractures are simple and can heal on their own without the participation of a specialist.

However, the lack of qualified and timely treatment can lead to the development of many complications, which will subsequently cause more inconvenience than the injury itself.

Classification

Fractures of the toes can be open or closed. Most often, such injuries are not accompanied by damage to the skin.

In most cases, toe fractures are not accompanied by damage to the skin, that is, they are closed.

By the presence of displacement, closed and open fractures of the toes can be:

• offset;
• no offset.

Fractures of the toes with displacement can be:

• angular offset;
• with wedging;
• with side shift;
• with longitudinal divergence;
• with longitudinal engagement.

Angular displacement of fragments of the phalanges occurs more often in children and is rarely observed.This fact is explained by the fact that at this age the periosteum remains elastic and may not be damaged by mechanical stress. In such cases, the broken bone is not completely held on it, and the fragment is displaced in the direction opposite to the fracture line.

The wedging of fragments in fractures of the toes is detected in 1 / 4-1 / 3 cases, since during the injury the direction of the impact often coincides with the longitudinal axis of the toe. However, wedging of one fragment into another is rare. As a rule, there is a strong deformation of the cartilaginous tissue, accompanied by the appearance of several sub-articular cracks.

Lateral displacement of fragments with such fractures is extremely rare.

Fractures with a longitudinal overlap of fragments for each other are observed more often than injuries with a discrepancy, because in such cases, muscle contraction occurs and the surrounding tissues are pulled together, shifting the fragments. Longitudinal divergence in such injuries occurs with significant damage to the ligaments and muscles in the fracture area.

By the number of fragments, fractures of the toes are divided into:

• slip-free;
• one- or two-splinted;
• multi-chipped.

Splinter-free fractures usually occur in falls. One- and two-splintered – when struck with a blunt object, and multi-splintered – when hit by an object with an uneven surface (for example, a stone).

Depending on the fault line, the fracture may be:

• transverse;
• longitudinal;
• oblique;
• helical;
• T-shaped;
• S-shaped, etc.

Depending on the location of the fault line, injuries can occur in the following areas of the toe:

• main phalanx;
• nail phalanx;
• middle phalanx.

Sometimes two or more phalanges are damaged at the same time. A fracture of the big toe is isolated separately, since it consists not of three, but of two phalanges. Symptoms when it is damaged are more pronounced, since it carries the maximum load when walking.

Symptoms

Signs of toe fractures are divided into probable and reliable.

Possible symptoms of a broken toe include the following:

• Pain in the injured finger;
• redness and swelling of tissues in the area of ​​the fracture;
• increase in tissue temperature in the area of ​​injury;
• restriction or complete absence of movement of the injured finger;
• Increased pain when tapping on the end of the finger;
• Forced position of the injured finger.

Pain in such fractures can be different in intensity, but they are always tolerable and do not lead to loss of consciousness, as is the case with injuries of larger bones.

Particularly acute and strongly painful sensations are expressed precisely at the moment of bone fracture, since the periosteum is highly innervated. After a short time, the pain becomes dull and is caused by the development of bleeding, the appearance of edema and an inflammatory reaction.

In case of injury, substances such as serotonin, histamine and bradykinin are released into the bloodstream, which provoke the development of an inflammatory process in the area of ​​damage.As a result, swelling and redness appear in this place, and the temperature of the inflamed tissues rises. To reduce pain, the victim tries to find a position for the finger in which it will manifest itself to a lesser extent.

Sign of increased pain when tapping on the top of the injured finger is a kind of test for determining a bruise or fracture of the finger.

In case of violation of the integrity of one of the phalanges, pain appears at the site of its fracture, and with bruises of the finger, such sensations do not arise.It should be noted that such actions cannot be performed if there is a suspicion of displacement of fragments. In such cases, performing the test can provoke further misalignment and exacerbate the injury.

Significant symptoms of a toe fracture include the following:

• detection of phalanx bone defect during palpation;
• pathological mobility of the phalanx in an unusual place;
• crepitus of fragments during palpation;
• the injured toe becomes shorter than the same healthy toe on the other leg;
• a broken finger deformity appears.

Such reliable signs of a fracture in almost 100% of cases indicate the presence of a fracture, but manipulations associated with palpation are always accompanied by severe pain and should be performed only by a specialist and as carefully as possible. Usually they are not performed, and the diagnosis is confirmed by X-ray.

First aid

An open wound should be treated with an antiseptic solution and applied with a sterile bandage.

As with other injuries accompanied by a violation of the integrity of the bone, first aid for fractures of the toes is aimed at eliminating pain, disinfecting wounds (if any), reducing hemorrhages and immobilizing the injured limb.It consists in carrying out the following activities:

1. Eliminate the traumatic factor and seat the patient in a comfortable position, giving the leg an elevated position.
2. Give an analgesic drug to take: Analgin, Nimesil, Ibufen, Ketanol, etc. Or, if possible, perform an intramuscular injection of an analgesic.
3. In the presence of open wounds, treat them with an antiseptic solution and apply a bandage from a sterile bandage.
4. Immobilization should be performed only if fragments are suspected to be displaced.In other cases, it is enough to give the leg an elevated position. If you need to immobilize your thumb, handy tools such as two pencils or plates covered with two layers of cloth can be used. They are held to the right and left of the toe and are bandaged to the shin. When immobilizing other toes of the foot, there is no need to use a splint – the injured toe is bandaged to one or two healthy toes.
5. Apply cold to the area of ​​injury to reduce pain and bleeding.Every 10 minutes the ice pack should be removed for 2-3 minutes to prevent frostbite.
6. To transport a patient to a hospital, it is better to call an ambulance or carry out this event on your own, but as sparingly as possible for the injured leg.

Diagnostics

Radiography is the gold standard for diagnosing fractures of the toes. The images are taken in one or two projections and allow you to create an accurate picture of the injury: displacement, fracture location, etc.p.

Treatment

The tactics of treating a fracture of a toe is determined by the clinical picture of the injury. For bone healing, the following methods can be used:

• closed one-step reduction;
• skeletal traction;
• open reduction.

In case of open fractures, antibiotics are prescribed to prevent purulent complications and, if necessary, tetanus vaccination is performed.

Closed one-step reduction

This treatment is used to repair closed displaced fractures.

The area of ​​injury is anesthetized by injecting a local anesthetic into the surrounding soft tissues (after a preliminary test for an allergic reaction). As a rule, lidocaine or procaine is used for these purposes.

After the onset of the drug action, the injured finger is gradually extended. In parallel with this, the doctor performs the return of the fragments to the physiological position.

After matching the fragments, the mobility of all joints (metatarsophalangeal and interphalangeal) is checked.If not all joints remain mobile, then a second reduction is performed. If the movements in all joints persist, then immobilization is carried out using a plaster cast or other devices.

Skeletal traction

This method of treating fractures of the toes is indicated when closed reduction is not possible. For this, manipulations are performed to provide retraction and support of the distal fragment. They make it possible to prevent the divergence of fragments.

Skeletal traction is performed after local anesthesia. A special pin or nylon thread is drawn through the skin or nail phalanx, the ends of which are tied to give it the appearance of a ring. Subsequently, a wire hook is fixed to the gypsum, which will hold the ring in the position necessary for skeletal traction.

After performing these manipulations, the patient should wear a plaster cast for at least 2-3 weeks. At the same time, finger punctures are treated daily with antiseptic solutions (Cutasept, Betadine, alcoholic solution of iodine or brilliant green).After 2-3 weeks, the thread or pin is removed, and the finger is immobilized again for the same period for complete bone healing.

Open reduction

Indications for performing a surgical operation – intraosseous osteosynthesis – may be the following cases:

• open fracture;
• multi-splinter fracture;
• complications arising from other methods of treatment.

Such interventions allow restoring the integrity of the bone with visual control and provide high reliability of fixation of fragments using metal devices.

For intraosseous fixation, pins, screws, plates and wires are used. The selection of this or that device is determined by the clinical picture of the fracture. After the completion of the operation, immobilization is performed using a splint or plaster cast for 4-8 weeks.

In more rare cases, osteosynthesis is performed using a system of metal rods fixed with circles or half-arcs – the Ilizarov apparatus. This is due to the cumbersomeness of such structures or the lack of apparatus of the required dimensions.

Possible complications

In the absence of treatment, non-compliance with the doctor’s recommendations or inadequate choice of the method of treatment, the following complications may develop:

• false joint;
• giant callus;
• Incorrect fusion of fragments;

90,011 ankylosis;

• osteomyelitis;
• gangrene.

Is plaster always applied

For immobilization in case of fractures of the toes, a plaster cast or other polymeric materials can be used that can provide reliable immobilization.For the patient, the most comfortable bandages are made of polymers, since

they are lighter and are not exposed to water (when wearing them there are no restrictions on hygiene measures). In addition, polymeric materials, unlike gypsum, always remain warm and do not “cool” the leg. Such hypothermia when wearing a plaster cast can lead to a violation of the strength of the callus.

The only drawback of polymers used for immobilization is their high cost.

An immobilizing bandage for fractures of toes is applied not only to the injured toe, but also covers the entire foot and the lower third of the lower leg. Only with this method of applying a “boot” bandage is it possible to achieve complete immobilization, which is necessary for a successful bone fusion.

In some cases, immobilization is not performed. These exceptions include:

• cracks in the phalanges – they are repaired on their own;
• first days after surgery on the leg with concomitant fracture of the fingers – a plaster cast is applied after the beginning of the healing of the postoperative wound;
• Use of the Ilizarov apparatus – fixation of fragments is provided by the device itself.

How long the plaster lasts

The duration of limb immobilization in case of toe fractures depends on many factors – the complexity of the injury, age, concomitant pathologies that impede bone fusion. Dates of wearing plaster can be as follows:

• for closed fractures without displacement – 2-3 weeks, working capacity is restored in 3-4 weeks;
• for fractures with displacement or the presence of multiple fragments – 3-4 weeks, working capacity is restored after 6-8 weeks;
• for open fractures or after osteosynthesis – 5-6 weeks, work capacity is restored after 9-10 weeks.

Rehabilitation

Physiotherapy exercises helps to restore the functions of the damaged finger.

The duration of rehabilitation after fractures of the toes depends on the same factors as the duration of immobilization. As a rule, the recovery period is about 3-4 weeks, but with multi-splinter injuries it is extended by 2 weeks. The development of complications leads to a significant slowdown in rehabilitation – it is almost doubled.

To restore the functions of the damaged finger, the following are assigned:

• physiotherapy exercises;
• massage courses;
• physiotherapy procedures (UHF, hot salt or ozokerite applications, mechanotherapy, salt and soda baths).

A fractured toe should always be a reason to see a doctor.

Incorrect treatment of such injuries can lead to the development of serious complications that will cause the victim a lot of suffering and worsen his quality of life.

To eliminate such fractures, various techniques can be used, the choice of which depends on the nature of the fracture. If all the doctor’s recommendations are followed and the correct choice of the method of treatment, such injuries respond well to therapy.

Which doctor to contact

If you suspect a toe fracture, you should consult an orthopedist. After examining the victim, the doctor will definitely prescribe an X-ray and, based on its results, draw up the most effective treatment plan.

Source: https://myfamilydoctor.ru/priznaki-pereloma-palca-na-noge-lechenie/

Fracture of the little toe: symptoms, first aid, treatment

The bones of the little finger are thin compared to other bones of the skeleton.Therefore, a fracture of the little toe is not uncommon. The probability of injuring the little toe is 5% of the sum of all fractures of the lower extremities. If we take into account the cases where the fracture has not been treated, the percentage will increase to 15%.

Reasons

A common cause of a broken toe is trauma to the toe. Since the bone of the little finger is small and fragile, a weak impact is enough to cause a fracture.

The fall of a heavy object on the little finger or the impact of a finger on a hard corner is enough to get the little toe fractured.

Another common cause leading to a fracture of the phalanx of the little finger is a pathological factor. This happens when there is insufficient bone strength due to a disease, for example:

• tuberculosis;
• osteoporosis;
• the presence of tumors in the body;
• osteomyelitis, etc.

A fracture of the little toe is often caused by players in team sports such as football, field hockey, rugby. Despite the fact that the bone of the little finger is small and fragile, the fusion process takes a long period of time and requires maximum effort and patience.

Symptoms

Symptoms of a fracture of the little finger on the leg are pronounced, which makes it possible for the traumatologist to make the correct diagnosis and start treatment. When the little toe is broken, the person experiences the following symptoms:

1. Acute local pain (directly in the little finger), or pain that covers the entire foot.
2. The appearance of edema. Immediately after the fracture, the foot becomes larger in size. The inflammatory process starts and the permeability of the walls of blood vessels increases.The process of edema performs a protective function; in case of a comminuted fracture, the swollen tissues prevent the displacement of bone fragments, which helps to avoid surgical intervention.
3. Bruising (bruising). The phalanges of the finger are equipped with their own network of blood vessels and are well supplied with blood. When a bone fracture occurs, the walls of the blood vessels are damaged and some of the blood seeps into the soft tissue, which gives the injured toe a blue color.
4. When the little finger is fractured with an offset, a deformity of the finger is formed, which is noticeable even to an inexperienced person.
5. An open fracture is accompanied by damage to the skin and the formation of a wound through which fragments of bone tissue are visible.

First aid for fracture of the little toe

In case of an open fracture, the first step is to disinfect the wound. Otherwise, the sequence of actions for a closed and open fracture is the same.

1. If a toe injury occurred while the foot was in the shoe, free the foot from the shoe and toe.The leg should be in a position that excludes even a slight impact on the toe. This will protect the victim from severe pain.
2. It is imperative to take an analgesic that is at hand. Fracture pain builds up gradually, to prevent the feeling of unbearable pain, it is important to take pain reliever right away. The drug takes time to take effect. The sooner the medicine enters the body, the faster the pain relief process will begin.
3. If a displaced toe fracture occurs, an immobilization process must be performed.This process involves fixing the injured toe by wrapping it around the adjacent, healthy toe. This procedure helps to exclude further displacement of the bone fragments. After the immobilization procedure, you can start transporting the patient to a medical facility. With a fracture without displacement, immobilization is not required.
4. Ice or cold object is applied to a broken finger. This will relieve pain and prevent swelling and inflammation.
5. When applying ice to an injured finger, avoid direct contact of the ice with the skin. You need to use a compress with ice wrapped in a towel or a special heating pad.

Diagnostics

It is possible to accurately determine the presence of a fracture of the little finger bone only with a doctor’s examination and examination of the fracture using an X-ray. An X-ray makes it possible to confirm or deny the diagnosis, to identify the type of fracture. There are several types of fracture:

1. Non-displaced bone fracture.This is a type of fracture in which two pieces of bone are juxtaposed.
2. Fracture of the little finger with displacement. With this type of fracture, parts of the bone are displaced, this type of fracture is rare, the recovery process is more difficult.
3. Comminuted fracture. A complex type of fracture, in which several fragments are formed at once. With this type of fracture, it is often necessary to resort to surgical intervention in order to bring the bone fragments together and fix them.

Treatment

There are two treatment options for the fracture:

• conservative method;
• surgical method.

Conservative treatment involves the application of a plaster cast over the injury site. In case of a fracture of the little finger with a displacement, a reduction procedure is preliminarily performed. The bone fragments are returned to the anatomically correct position and fixed with a plaster cast.

The process of reduction is carried out both without surgical intervention, and with its help. The doctor acts based on the type of fracture. Surgical reduction is used for comminuted fractures.

Bone fragments are fixed using a plate, this method is called osteosynthesis.To avoid possible complications, the victim is prescribed pain relievers and anti-inflammatory drugs.

Do you have to wear plaster cast if your little toe is broken?

A fracture of the little toe does not always require a plaster cast, it is determined based on which part of the toe is injured. The decision to apply a plaster cast is made by the doctor.

• If the nail phalanx is broken, then the case can be done with a perforation procedure, the doctor will make an incision to rid the finger of blood accumulations.
• If the main or middle phalanx of the toe is broken, then the entire foot is fixed with a plaster cast, and it is removed only after the final fusion of the bone.
• It is also possible to install a pin or staples, depending on the complexity of the fracture.

The plaster cast can be replaced with a modern and comfortable analogue – scotch tape. It is a synthetic bandage impregnated with a special type of resin, which solidifies when wet. The doctor may suggest the use of a special brace for the little toe in case of a fracture.

How long does it take for the fracture of the little toe to heal?

The healing time of the bones of the little finger is individual and depends on the characteristics of the organism, the age of the patient, the nature of the fracture, etc. On average, it will take 1-2 months for the fracture to heal without displacement.

Rehabilitation

The main condition for quick recovery is the state of rest of the injured limb. The leg should not be stressed.

After the doctor concludes that the little finger bone has grown together, the plaster cast will be removed and the rehabilitation period will begin.

This period is for the development of the damaged toe in order to return it to its previous functionality and gradually prepare the finger for maximum stress.

The rehabilitation period consists of exercise therapy (physiotherapy exercises), a course of massage and physiotherapy procedures, enrichment of the diet with foods containing a lot of calcium, which helps to strengthen bone tissue.

Complications

Basically, a fracture of the little toe on the leg is not accompanied by pronounced clinical symptoms.Therefore, there is a late diagnosis of the injury. If the pain is tolerable, some patients prefer to endure and do not seek advice from a traumatologist. In others, the fracture of the little finger goes completely unnoticed.

Inattentive treatment of the body and health can lead to serious consequences, which are extremely difficult to reverse.

Large callus

The formation of callus occurs when any fracture heals. This connective tissue is formed to connect the fragments of the bone, ensuring its continuity and restoration of previous functions.The size of the callus depends on the distance between the bone fragments.

The more accurately the parts of the bone are matched, the thinner the callus will be, and the healing process will be faster. If a person does not seek qualified help and bone fragments are not repositioned, this contributes to the excessive proliferation of connective tissue between all fragments.

The result is slow healing of the injury, regular pain and inflammation.

False joint formation

Ignoring a displaced fracture leads to such a complication. Due to the distant bone fragments, the fusion process does not start.

The process of closing the bone canals begins, rounding off the fragments and the formation of two phalanxes in place of one phalanx. However, such a joint is not considered complete due to the lack of cartilage tissue between the bones.

As a result, the constant rubbing of the bones against each other causes severe pain and provokes an inflammatory process.Such a finger cannot fully fulfill its function.

Ankylosis

Ankylosis is the closure of the joint space by the fusion of two phalanges. This phenomenon is common when the little toe is fractured. It is connected with the anatomical structure of the bone of this finger.

The phalanges of the little finger are short, and the fracture affects the bone below the joint surface (subchondral region). A violent inflammatory process begins, which contributes to the fusion of the joint space.

First, callus is formed, which eventually turns into bone tissue.

Osteomyelitis

Osteomyelitis is a severe consequence of bone fracture, which is difficult to treat. This is a purulent-necrotic process that takes place in the bone marrow and bones, affecting the surrounding soft tissues.

This process is a consequence of an open fracture, when bacteria and harmful microorganisms from the external environment penetrate into the inner layer of the bone. Therefore, it is so important to treat an open fracture with a disinfectant.

Fracture of the little toe is a dangerous and intractable injury.If you do not pay enough attention, in the long term there is a possibility of losing the functionality of the finger. If you find the slightest signs of a fracture of the little toe, even in the absence of pronounced symptoms, you need to contact a competent doctor who will provide the necessary medical assistance.

Source: https://ChtoiKak.ru/perelom-mizinca-na-noge.html

90,000 Treatment of improperly fused fractures – Surgery Center CM-Clinic St. Petersburg

There are contraindications.Consultation of a specialist is required.

Insufficient fixation of the fracture, early removal of the plaster cast, excessive loads when the bone has not yet healed can lead to improper healing of the fracture. Because of this, limb shortening, impaired motor function, muscle atrophy can occur. In order to restore the normal functions of the damaged area of ​​the body, it is necessary to begin treatment of the incorrect healed fracture as early as possible.

Operation

Before prescribing treatment for improperly fused fractures, in order to accurately determine the type of deformity, the doctor will examine the patient, and also prescribe a robe of studies:

• roentgen;
• examination of blood vessels;
• Study of nerve conduction.

Routine preoperative tests will also be ordered to provide a complete picture of the patient’s health. Elimination of bone deformation is carried out exclusively by an operative method.

During the procedure, the doctor re-separates the bones and then fixes them in the correct position. During the intervention, the patient is under anesthesia without experiencing any pain. In some cases (with a strong displacement), in addition to eliminating the deformity, bone grafting (bone grafting to replace the damaged area) is indicated.

Recovery

The first day or two, the patient is shown being in the hospital. In total, recovery takes an average of 1.5 months. During this time, the patient must regularly come to the doctor’s examinations to monitor the process of restoring the integrity of the bone.

To avoid re-deformation, it is extremely important to minimize the stress on the injured limb until it is fully restored.

Abnormal fusion of bones is a fairly common complication of fractures.Treatment of incorrectly fused fractures requires high professionalism from doctors, since it is necessary to exclude the likelihood of re-deformity.

If your bones have not grown properly after a fracture, then contact the specialists of the medical center “CM-Clinic” for help by phone in St. Petersburg: +7 (812) 435-55-55

The author of the article:

Nikitin Alexander Vladimirovich operating traumatologist at the “SM-Clinic”
90,000 Calcium for bones in fractures: prevention of fractures in children

Contents

A fracture occurs when the pressure on the bone exceeds the allowable load.There are conditions that weaken the bone (for example, osteoporosis), and then a minimal amount of exposure is enough for a fracture to occur.

Among all injuries, bone fractures account for about 21.5% ¹ . Fracture healing is an important physiological process that requires significant efforts from the body. Incorrect fusion leads to severe dysfunctions of the musculoskeletal system and a deterioration in the quality of life. Rehabilitation after fractures takes from 5-6 weeks to a year or more.To accelerate recovery, a sufficient amount of calcium must be supplied to the body, which forms the basis of bone tissue in the form of hydroxyapatite.

Should I take calcium in case of fracture?

Calcium enters the body only from the outside and in case of deficiency is washed out from the bones so that its level in the blood remains unchanged. This is why the use of calcium is of great help in fracture healing.

The following are involved in the regulation of calcium metabolism:
– hormones of the parathyroid gland;
– vitamin D, on which the absorption of the mineral in the intestine and its entry into the bone tissue depends (with a lack of vitamin D, calcium is not absorbed, does not enter the bone in sufficient quantities: because of this, the density decreases).

The balance of calcium and vitamin D is the basis for the formation of healthy bone. Studies have shown that calcium supplements are effective in accelerating the healing of bone fractures ² , especially in osteoporosis. These agents improve the process of macronutrient deposition in bones and stimulate the formation of callus, an important stage in fracture healing.

Calcium preparations for bone fractures

Three generations of products for the treatment of injuries and diseases of the skeletal system have been created:

Simple calcium salts (carbonate, citrate, lactate, gluconate, phosphate) – preparations that contain only one component.The bioavailability of calcium from them is relatively low, that is, a small amount of the mineral enters the bone tissue. To improve absorption, they must be combined with vitamin D3.

A combination of calcium salts (more often – carbonate) and vitamin D. They do not solve all problems, since other microelements are also needed to restore the elasticity and strength of bones. ⁴ .

Calcium preparations with vitamin D, which also include other minerals (magnesium, zinc, copper, manganese, boron).Examples are Calcemin® and Calcemin® Advance, which are prescribed for bone fractures in children and adults ⁵ . Such funds provide not only the intake of an adequate dose of calcium and vitamin D, but also other important microelements., Lost by her throughout her life ³ .

If a child (adolescent) has not gained peak bone mass, he may have an increased risk of osteoporosis in the future. People who do not consume enough calcium-rich foods, such as dairy products, are also at risk.

What calcium supplements are best for bone fractures?

Many minerals and microelements are involved in the construction of bone tissue ⁶ . To speed up the healing process, after a fracture, you should take funds that include:

– Magnesium. Regulates bone metabolism, its mineralization, maintains flexibility and strength, enhances the ability to recover from fractures. Its use increases bone mineral density ⁷ .Insufficient magnesium intake can lead to osteoporosis and low bone mass. The consumption rate is 400 mg / day.

– Zinc. Participates in many metabolic processes, it is fundamentally important for DNA reproduction. Bone tissue contains approximately 30% of zinc in the whole body ⁶ . Its concentration in the bones decreases rapidly if the intake decreases or the absorption of the microelement is impaired. Due to zinc deficiency, defects in the development of bone tissue are possible. The admission rate for adults is 12 mg / day ⁶ .

– Copper. A component of enzymes that are involved in the exchange of iron, providing tissues with oxygen. In the bone tissue, it is responsible for the formation of collagen, its connection with elastin and the general mineralization of the skeleton. Copper deficiency leads to disturbances in the formation of bone and connective tissue, inhibition of bone growth. The need for adults is 1 mg / day ⁶ .

– Manganese. Also participates in all types of metabolism (carbohydrates, fats, amino acids). Manganese deficiency can lead to reproductive disorders, as well as lead to increased bone fragility ⁸ .A daily intake of 2 mg of manganese is required.

– Bor. Affects the metabolism of vitamin D, the content of calcium, phosphorus, magnesium in bones. Improves the absorption of calcium, prevents the decrease in bone density and the development of osteoporosis. Up to 2 mg of boron ⁶ should be ingested daily.

To increase the effectiveness of fracture treatment, it is advisable to additionally take calcium as part of combination drugs (especially for the elderly). Calcemin® products provide an additional supply of calcium, vitamin D and other trace elements necessary for the timely healing of fractures ⁴ .They also promote callus formation and bone density to prevent re-injury.

Prevention of fractures

Prevention of osteopenia (decrease in bone mineral density without structural changes in bone tissue) and osteoporosis is important to prevent fractures. For this purpose, prophylactic doses of calcium and vitamin D are prescribed, a set of physical exercises is developed or the optimal sport is selected (gymnastics, running, swimming).