How long does a broken toe take to heal. What are the symptoms of a broken toe. How to treat a broken toe at home. When to seek medical help for a broken toe. What activities can you do with a broken toe. How to manage pain from a broken toe. What complications can arise from a broken toe.

Understanding Broken Toes: Causes, Types, and Severity

Broken toes are a common injury that can occur due to various reasons, such as dropping a heavy object on the foot or stubbing the toe against a hard surface. While most broken toes can be treated at home, it’s crucial to understand the different types and severity levels of these injuries.

Toe fractures can be classified into two main categories:

• Simple fractures: These are clean breaks in the bone without displacement.
• Compound fractures: These involve an open wound and possible bone displacement.

Severe toe injuries that require immediate medical attention include:

• Breaks that cause the toe to be crooked
• Fractures resulting in an open wound
• Injuries involving the big toe

In rare cases, tiny bone fragments can break off, potentially impeding proper healing. Such situations may necessitate surgical intervention.

Recognizing the Symptoms of a Broken Toe

Identifying a broken toe is crucial for proper treatment and recovery. The primary symptoms of a broken toe include:

• Pain: Often intense and localized to the affected toe
• Swelling: The toe and surrounding area may become puffy
• Bruising: Can last up to 2 weeks
• Stiffness: Difficulty moving the toe

Can a broken toe heal on its own? In most cases, yes. The majority of broken toes will heal without surgical intervention, provided proper care is taken at home. However, if the toe appears crooked after the injury, it may indicate that the bone is out of place and might require realignment, either with or without surgery.

Timeline for Broken Toe Healing

Understanding the healing process can help manage expectations and ensure proper care. Here’s a general timeline for broken toe recovery:

• 4 to 6 weeks: Complete healing time for most broken toes
• Few days to a week: Most pain and swelling subsides
• 6 to 8 weeks: Healing time for more severe injuries requiring casting, reduction, or surgery

Immediate Care and Pain Management for Broken Toes

The first few days following a toe injury are crucial for proper healing and pain management. Here are some immediate steps to take:

1. Rest: Stop any physical activity that causes pain and keep your foot immobile when possible.
2. Ice: For the first 24 hours, apply ice to your toe for 20 minutes every hour while awake, then 2 to 3 times a day. Avoid direct ice contact with the skin.
3. Elevation: Keep your foot raised to reduce swelling.
4. Pain medication: Use over-the-counter pain relievers as needed.

Which pain medications are suitable for a broken toe? Common options include:

• Ibuprofen (Advil, Motrin)
• Naproxen (Aleve, Naprosyn)
• Acetaminophen (Tylenol)

It’s important to consult with a healthcare provider before taking any medication, especially if you have pre-existing health conditions or are taking other medications.

Effective Home Care Techniques for Broken Toes

Proper home care is essential for the healing of most broken toes. Two key techniques can significantly aid in recovery:

Buddy Taping

Buddy taping is a simple yet effective method to stabilize a broken toe:

1. Wrap tape around the injured toe and the adjacent toe.
2. Place a small wad of cotton between the toes to prevent moisture buildup.
3. Change the cotton daily to maintain hygiene.

Appropriate Footwear

Choosing the right footwear is crucial for protecting the injured toe and allowing space for swelling:

• Initially, a stiff-bottomed shoe provided by a doctor may be necessary.
• Once swelling subsides, switch to a solid, stable shoe for continued protection.

Gradual Return to Activity: A Balanced Approach

Returning to normal activities after a broken toe requires a careful, gradual approach. Here’s how to safely increase your activity level:

1. Start by slowly increasing the amount of walking you do each day.
2. Resume normal activity once swelling has subsided and you can wear a stable, protective shoe.
3. Expect some initial soreness and stiffness when walking, which will improve as the toe muscles stretch and strengthen.
4. Apply ice to your toe after activity if you experience any pain.

Is it safe to exercise with a broken toe? While you should avoid high-impact activities initially, light exercises that don’t put pressure on the toe can be beneficial for maintaining overall fitness. Always consult with your healthcare provider before starting any exercise routine during recovery.

Potential Complications and When to Seek Medical Help

While most broken toes heal without complications, it’s important to be aware of potential issues that may arise:

• Chronic pain or stiffness
• Improper healing leading to toe deformity
• Arthritis in the affected joint
• Nail bed injuries or infections

When should you seek medical attention for a broken toe? Contact your healthcare provider if you experience:

• Severe pain that doesn’t improve with home care
• Signs of infection (increased redness, warmth, or discharge)
• Numbness or tingling in the toe
• Difficulty walking after several days of rest
• Visible deformity of the toe

Long-Term Care and Prevention of Future Toe Injuries

After your broken toe has healed, it’s important to take steps to prevent future injuries and maintain foot health:

1. Wear properly fitting shoes with adequate toe protection.
2. Practice good foot hygiene to prevent infections.
3. Strengthen your feet and toes with exercises recommended by a physical therapist.
4. Be mindful of your surroundings to avoid stubbing your toes.
5. Use caution when participating in high-risk activities for foot injuries.

How can you strengthen your toes after a break? Some effective exercises include:

• Toe curls with a towel
• Marble pickups using your toes
• Gentle toe stretches
• Ankle rotations to improve overall foot strength

Remember to start these exercises only after your healthcare provider has cleared you for such activities.

Nutritional Support for Optimal Bone Healing

Proper nutrition plays a crucial role in bone healing. Incorporating certain nutrients into your diet can support the recovery process:

• Calcium: Essential for bone strength and repair
• Vitamin D: Aids in calcium absorption
• Protein: Supports tissue repair and bone matrix formation
• Vitamin C: Necessary for collagen production
• Zinc: Promotes bone healing and immune function

Which foods are best for promoting bone healing? Consider incorporating these nutrient-rich options into your diet:

• Dairy products or fortified plant-based alternatives
• Leafy green vegetables
• Fatty fish like salmon or sardines
• Lean meats and legumes
• Citrus fruits and berries
• Nuts and seeds

Consulting with a nutritionist can help you develop a personalized diet plan to support your recovery.

Understanding the Impact of Lifestyle Factors on Toe Fracture Recovery

Various lifestyle factors can significantly influence the healing process of a broken toe. Being aware of these factors and making appropriate adjustments can contribute to a faster and more effective recovery:

Smoking and Alcohol Consumption

Both smoking and excessive alcohol consumption can negatively impact bone healing:

• Smoking: Reduces blood flow to the bones, slowing the healing process
• Alcohol: Can interfere with the body’s ability to absorb calcium and other essential nutrients

Quitting smoking and limiting alcohol intake during recovery can significantly improve healing outcomes.

Sleep and Stress Management

Adequate sleep and stress reduction are crucial for optimal healing:

• Aim for 7-9 hours of quality sleep per night
• Practice stress-reduction techniques such as meditation or deep breathing exercises
• Consider gentle yoga or stretching routines that don’t put pressure on the injured toe

Hydration

Proper hydration is essential for overall health and can support the healing process:

• Aim to drink 8-10 glasses of water per day
• Increase intake if you’re physically active or in hot weather
• Herbal teas can be a good alternative for variety

How does staying hydrated help with bone healing? Adequate hydration supports blood flow, nutrient transport, and waste removal, all of which are crucial for the healing process.

The Role of Physical Therapy in Broken Toe Recovery

While many broken toes heal without the need for physical therapy, in some cases, especially for more severe injuries or those involving the big toe, physical therapy can be beneficial:

Benefits of Physical Therapy

• Improves range of motion
• Strengthens surrounding muscles
• Reduces the risk of long-term stiffness
• Helps prevent future injuries

Common Physical Therapy Techniques

1. Manual therapy to improve joint mobility
2. Exercises to strengthen foot and toe muscles
3. Balance and proprioception training
4. Gait analysis and correction if needed

When should you start physical therapy for a broken toe? Usually, physical therapy begins once the initial healing phase is complete, typically 4-6 weeks after the injury. However, always consult with your healthcare provider for personalized advice.

Psychological Aspects of Dealing with a Broken Toe

The impact of a broken toe extends beyond physical discomfort. It’s important to address the psychological aspects of dealing with this injury:

Common Emotional Responses

• Frustration due to limited mobility
• Anxiety about the healing process
• Depression from inability to participate in regular activities
• Impatience with the recovery timeline

Coping Strategies

1. Set realistic expectations for recovery
2. Focus on activities you can do rather than those you can’t
3. Practice mindfulness or meditation to manage stress
4. Seek support from friends, family, or a support group
5. Consider talking to a mental health professional if you’re struggling to cope

How can you maintain a positive outlook during recovery? Try to view this period as an opportunity for personal growth, learning new skills, or catching up on activities that don’t require much mobility, such as reading or learning a new language.

Innovative Treatments and Future Prospects in Toe Fracture Management

While traditional methods remain effective for most broken toes, research continues to explore innovative treatments that could improve recovery outcomes:

Emerging Treatments

• Low-intensity pulsed ultrasound (LIPUS) therapy
• Platelet-rich plasma (PRP) injections
• Bone morphogenetic proteins (BMPs)
• 3D-printed casts and splints

Potential Benefits

1. Faster healing times
2. Reduced pain during recovery
3. Improved bone strength post-healing
4. More comfortable and hygienic support options

Are these new treatments widely available for broken toe management? While some of these treatments are being used for other types of fractures, their application in toe fractures is still largely experimental. Always consult with your healthcare provider about the most appropriate and evidence-based treatments for your specific situation.

As research progresses, we may see more personalized and effective treatments for broken toes in the future, potentially leading to faster recovery times and better long-term outcomes.

Broken toe – self-care Information | Mount Sinai

Fractured toe – self-care; Broken bone – toe – self-care; Fracture – toe – self-care; Fracture phalanx – toe

More About Your Injury

Broken toes are a common injury. The fracture is most often treated without surgery and can be taken care of at home.

Severe injuries include:

• Breaks that cause the toe to be crooked
• Breaks that cause an open wound
• Injuries that involve the big toe

If you have a severe injury, you should seek medical help.

Injuries that involve the big toe may need a cast or splint to heal. In rare cases, tiny pieces of bone can break off and keep the bone from healing properly. In this case, you may need surgery.

What to Expect

Symptoms of a broken toe include:

• Pain
• Swelling
• Bruising that can last up to 2 weeks
• Stiffness

If your toe is crooked after the injury, the bone may be out of place and may need to be straightened in order to heal properly. This may be done either with or without surgery.

Most broken toes will heal on their own with proper care at home. It can take 4 to 6 weeks for complete healing. Most pain and swelling will go away within a few days to a week.

If something was dropped on the toe, the area under the toenail can bruise. This will go away in time with nail growth. If there is substantial blood under the nail, it may be removed to reduce pain and potentially prevent the loss of the nail.

Symptom Relief

For the first few days after your injury:

• Rest. Stop doing any physical activity that causes pain, and keep your foot immobile whenever possible.
• For the first 24 hours, ice your toe for 20 minutes every hour you are awake, then 2 to 3 times a day. Do not apply ice directly to the skin.
• Keep your foot raised to help keep swelling down.
• Take pain medicine if necessary.

For pain, you can use ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn).

• If you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or bleeding, talk with your health care provider.
• Do not give aspirin to children.

You may also take acetaminophen (such as Tylenol) for pain relief. If you have liver disease, talk with your provider before using this medicine.

Do not take more than the amount recommended on the medicine bottle or by your provider.

Your provider may prescribe a stronger medicine if needed.

Self-care at Home

To take care of your injury at home:

• Buddy taping. Wrap tape around the injured toe and the toe next to it. This helps keep your toe stable. Place a small wad of cotton between your toes to prevent tissues from becoming too moist. Change the cotton daily.
• Footwear. It may be painful to wear a regular shoe. In this case, your doctor can provide a stiff-bottomed shoe. This will protect your toe and make room for swelling. Once swelling has gone down, wear a solid, stable shoe to protect your toe.

Activity

Slowly increase the amount of walking you do each day. You can return to normal activity once the swelling has gone down, and you can wear a stable and protective shoe.

There may be some soreness and stiffness when you walk. This will go away once the muscles in your toe begin to stretch and strengthen.

Ice your toe after activity if there is any pain.

More severe injuries that require casting, reduction, or surgery will take time to heal, possibly 6 to 8 weeks.

Follow-up

Follow up with your provider 1 to 2 weeks after your injury. If the injury is severe, your provider may want to see you more than once. X-rays may be taken.

When to Call the Doctor

Call your provider if you have any of the following:

• Sudden numbness or tingling
• A sudden increase in pain or swelling
• An open wound or bleeding
• Fever or chills
• Healing that is slower than expected
• Red streaks on the toe or foot
• Toes that appear more crooked or bent

Alkhamisi A. Toe fractures. In: Eiff MP, Hatch RL, Higgins MK, eds. Fracture Management for Primary Care and Emergency Medicine. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 16.

Rose NGW, Green TJ. Ankle and foot. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 49.

Last reviewed on: 4/16/2022

Reviewed by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Toe Injury

Is this your child’s symptom?

• Injuries to toes

Types of Toe Injuries

• Cuts, Scrapes and Bruises. These are the most common injuries.
• Jammed Toe. The end of a straightened toe receives a blow. This is usually from stubbing the toe on an object. The energy is absorbed by the joint surface and the injury occurs there. This is called traumatic arthritis.
• Crushed or Smashed Toe. This is usually from something heavy falling on the toe. Sometimes, the nail can be damaged. Fractures are unusual, but are at risk for a bone infection (osteomyelitis).
• Toenail Injury. If the nailbed is cut, it may need sutures to prevent a permanently deformed nail. This is less important for toenails.
• Subungual Hematoma (Blood Clot under the Nail). Most often caused by a crush injury. It can be from a heavy object falling on the nailbed. Many are only mildly painful. Some are severely painful and throbbing. These need the pressure under the nail released. A doctor can put a small hole through the nail to release the blood. This can relieve the pain and prevent loss of the nail.
• Dislocations. The toe has been pushed out of its joint.
• Fractures. Toe has a broken bone. The treatment is the same whether the toe is broken or just bruised. Broken toes are not put in a cast.

Concerns About Missing a Broken Toe

• Most swollen, bruised and painful toes are not broken.
• X-rays are only needed for severe pain and severe injuries.
• If the big toe might be broken, it should be seen by a doctor. The other injured toes generally don’t need to be seen.
• A broken great toe is not urgent. It can be checked during office hours.
• The treatment is the same whether or not the toe is broken.
• The treatment of all broken toes is pain medicine and comfortable footwear.

Pain Scale

• Mild: Your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
• Moderate: The pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
• Severe: The pain is very bad. It keeps your child from doing all normal activities.

When to Call for Toe Injury

Call Doctor or Seek Care Now

• Skin is split open or gaping and may need stitches
• Large swelling is present
• Blood under a nail is causing more than mild pain
• Nail is torn
• Base of nail has popped out from under the skin fold
• Dirt in the wound is not gone after 15 minutes of scrubbing
• Skin or nail is cut and No past tetanus shots. Note: tetanus is the “T” in DTaP, TdaP, or Td vaccines.
• Severe pain and not better 2 hours after taking pain medicine
• Age less than 1 year old
• Age less than 2 years and toe tourniquet suspected. (Hair wrapped around toe, groove, swollen red or bluish toe)
• You think your child has a serious injury
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• Broken toe suspected
• Toe injury that causes bad limp
• Dirty cut or hard to clean and no tetanus shot in more than 5 years
• Clean cut and no tetanus shot in more than 10 years
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• Pain not better after 3 days
• Not using the toe normally after 2 weeks
• You have other questions or concerns

Self Care at Home

• Minor toe injury

Seattle Children’s Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

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  Bellevue
  
  
  
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  Everett
  
  
  
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  Federal Way
  
  
  
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  Seattle
  
  
  
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  Virtual Urgent Care
  
  
  

Care Advice for Minor Toe Injuries

1. What You Should Know About Toe Injuries:
   • There are many ways that children can hurt their toes.
   • There are also many types of toe injuries.
   • You can treat minor toe injuries at home.
   • Here is some care advice that should help.
2. Pain Medicine:
   • To help with the pain, give an acetaminophen product (such as Tylenol).
   • Another choice is an ibuprofen product (such as Advil).
   • Use as needed.
3. Bruised/Swollen Toe:
   • Soak in cold water for 20 minutes.
   • Repeat as needed.
4. Small Cuts or Scratches:
   • For any bleeding, put direct pressure on the wound. Use a gauze pad or clean cloth. Press down firmly on the place that is bleeding for 10 minutes. This is the best way to stop bleeding. Keep using pressure until the bleeding stops.
   • Wash the wound with soap and water for 5 minutes.
   • For any dirt in the wound, scrub gently.
   • For any cuts, use an antibiotic ointment (such as Polysporin). No prescription is needed.
   • Cover it with a bandage (such as Band-Aid). Change daily.
5. Jammed Toe:
   • Caution: Be certain range of motion is normal. Your child should be able to bend and straighten each toe. If movement is limited, your doctor must check for a broken bone.
   • Soak the foot in cold water for 20 minutes.
   • If the pain is more than mild, “buddy-tape” it to the next toe.
6. Smashed or Crushed Toe:
   • Wash the toe with soap and water for 5 minutes.
   • For any cuts, use an antibiotic ointment (such as Polysporin). No prescription is needed.
   • Cover it with a bandage (such as Band-Aid). Change daily.
7. Torn Nail (from catching it on something):
   • For a cracked nail without rough edges, leave it alone.
   • For a large flap of nail that’s almost torn through, cut it off. Use a pair of scissors that have been cleaned. Cut along the line of the tear. Reason: Pieces of nail taped in place will catch on objects.
   • Soak the toe for 20 minutes in cold water for pain relief.
   • Use an antibiotic ointment (such as Polysporin). No prescription is needed. Then cover with a bandage (such as Band-Aid). Change daily.
   • After about 7 days, the nailbed should be covered by new skin. It should no longer hurt. A new nail will grow in over 6 to 8 weeks.
8. Remove Ring:
   • Remove any ring that is on an injured toe.
   • Reason: swelling may occur.
9. Shoes to Reduce Pain:
   • If regular shoes cause too much pain, make a change in footwear.
   • Wear a shoe with a firm sole to limit motion. Reason: Injured toes hurt when they bend (are flexed).
   • If the top of the shoe increases pain, wear an open-toe sandal. Another option is to use an old sneaker. Then cut out the part over the toe.
10. Buddy-taping:
    • Buddy-taping is taping the injured toe to the one next to it.
    • Method: Gauze padding must be placed between the toes before taping them together.
    • How long to buddy tape: Usually needed for 1 – 2 weeks. By then new bone formation will close the break. Then pain with movement will be reduced.
    • Usefulness: Buddy-taping is optional. Sometimes, it makes the pain worse. Wearing the right shoe is much more helpful.
11. Call Your Doctor If:
    • Pain becomes severe
    • Pain not better after 3 days
    • Toe not normal after 2 weeks
    • You think your child needs to be seen
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 07/25/2023

Last Revised: 12/30/2022

Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.

Treatment of a Broken Finger – Article

• Apply ice, apply a tight bandage and lift the injured area. Reduce swelling and pain with ice, a compressive bandage, and a finger lift. The sooner you apply these first aid methods after an injury, the better. Don’t forget to fix the injured finger as well.
• Apply ice to your finger. Wrap a bag of frozen vegetables or ice in a thin towel and gently apply it to your finger to reduce swelling and pain. Apply an ice pack immediately after injury for no longer than 20 minutes at a time.
• Compress the damaged area. Gently but firmly wrap the finger with a soft elastic bandage to reduce swelling and fix the fracture site. When you first visit your doctor, find out if a bandage is recommended to reduce swelling and secure your injured finger.
• Raise your hand. If possible, try to keep the injured finger above the level of the heart. For example, you can sit on the sofa with your feet and put your hand with the injured finger on the back of the sofa.
• Also try not to use the injured finger for daily activities until you have cleared this matter with your doctor.

• Ask your doctor if you need a splint. Splinters are sometimes placed on broken fingers to immobilize them and prevent further damage.
• The type of splint depends on which pin is damaged. For minor fractures, you can tie a finger to an adjacent one to immobilize it.
• Dorsal protruding splint from behind the toe prevents it from bending backwards. With a soft splint, you can gently bend your finger into the palm of your hand and carefully secure it in place with a soft bandage.
• Rigid U-shaped aluminum splint prevents finger from stretching. It is placed behind the damaged finger and firmly fixes it.
• In more serious cases, the doctor may apply a fixed fiberglass splint that extends from the finger past the wrist. Such a tire resembles a miniature plaster bandage for a finger.
• Check with your doctor if surgery is needed. Surgery may be needed to properly heal and heal the bone if conventional methods of fixation and treatment are ineffective. As a rule, operations are used for more complex fractures, for which one fixation of the finger is not enough.
• Operations are required for complex, open and unstable fractures, moving bone fragments or endangering the joint, that is, in cases where it is necessary to put the bones back in place so that they heal properly.

• Continue to see your doctor or appropriate specialists. Once a diagnosis has been made and treatment determined, your doctor may schedule a follow-up visit in a few weeks. After 1-2 weeks, the doctor may take another x-ray to determine how the treatment is progressing. Visit your doctor so that he can monitor the progress of the treatment.
• If you have any questions during treatment, please contact your doctor.
• Be prepared for possible complications. Typically, with proper treatment, finger fractures heal very well within 4 to 6 weeks. And although the risk of complications from a broken finger is minimal, it is still better to be aware of their danger:
  • The formation of scar tissue around a fracture can lead to joint stiffness. This problem can be dealt with through physical therapy, which will strengthen the muscles of the finger and reduce scar tissue.
  • As it heals, the knuckle of the finger may turn, resulting in deformity of the bone and preventing proper grip. In this case, surgery may be required.
  • Two fragments of a broken bone may not heal properly, which can lead to permanent instability at the fracture site. This is called “nonunion” of the bone.
  • In lacerations at the fracture site that are not properly cleaned before surgery, a skin infection may occur.

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Fractured finger in a child.

What is a finger fracture in a child?

IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

A finger fracture in a child is a violation of the integrity of the main, middle or nail phalanx of the finger on the arm or leg. It is manifested by pain, cyanosis, edema, hemorrhages, dysfunction, and sometimes external deformation. With damage to the nail phalanx, subungual hematomas often form. The diagnosis is inserted taking into account the circumstances of the injury, complaints, objective examination data and radiography results. According to the indications, CT or MRI is prescribed. Treatment – reposition, immobilization with a plaster cast or dynamic splinting. Sometimes fixation with a knitting needle is required. In the presence of wounds operation is shown.

ICD-10

S62.5 S62.6 S92.4 S92.5

• Causes
• Pathogenesis
• Symptoms
• Complications
• Diagnostics
• Treatment of a broken finger in a child
  • Conservative therapy
  • Surgical treatment
• Forecast
• Prophylaxis
• Prices for treatment

General

A broken finger in a child is a fairly common injury. Finger injuries account for about 2% of the total number of skeletal injuries, and toe fractures account for less than 1%. Most often, the nail phalanges suffer, somewhat less often – the middle ones, even more rarely – the main ones. Severe injuries are rare. The importance of early adequate treatment of injuries of the upper extremities is due to the need to preserve the function of the hand.

Fractured finger in a child

Causes

Finger fractures in children occur as a result of household, street and sports injuries. Injuries to the fingers can be caused by being hit by a heavy object such as a hammer, being caught in a door, a fight, or an unfortunate fall. Injuries to the toes are often the result of hitting a hard object, such as a doorpost at home or a goal post while playing football.

Pathogenesis

A fracture of the phalanx of the finger occurs as a result of a traumatic impact, the force of which exceeds the strength characteristics of the bone. There may be a violation of the integrity of the middle part or epiphyses of the phalanx. As a rule, the fracture is single, linear and not accompanied by significant displacement.

Multiple finger injuries and comminuted injuries with gross displacement are rare and require special attention due to possible negative consequences. Most fractures are closed. Separations of a part of the fingertip and the formation of a soft tissue defect in fractures of the terminal phalanx occur mainly in preschool children.

Symptoms

A child with a broken finger complains of sharp pain in the injured area. On examination, the finger is edematous, cyanotic. The injured phalanx is painful on palpation, axial load. In the presence of a significant displacement, shortening and deformation are detected. Fractures of the nail phalanges are often accompanied by the formation of extensive subungual hematomas. The function of the brush is reduced.

Signs of a fracture of the toe in children are rapidly increasing swelling, cyanosis, bruising, subungual hematomas, pain to palpation and pressure along the axis. The support on the leg is preserved, while standing and walking the child spares the front sections of the foot, leans on the ground mainly with the heel.

Open fractures are characterized by the presence of an irregularly shaped wound, often with crushed and crushed edges. In the wound, fat cells of the soft tissues of the phalanges are visible, sometimes bone fragments are visible. When a defect is formed, a part of the skin and underlying soft tissues is torn off or hanging on a thin skin flap that does not have feeding vessels.

Complications

With a pronounced displacement and the absence of reposition in the long term, finger deformities are formed. Unrepaired intra-articular fractures with displacement are fraught with limited mobility in the joint. In adulthood, children who have suffered finger injuries may develop post-traumatic arthrosis.

Diagnostics

Pediatric traumatologists are engaged in clarifying the nature of the injury. Recognition of a fracture is usually not difficult, due to a fairly bright clinical picture. Due to the impossibility of productive contact and ambiguous X-ray data, some difficulties may arise in the diagnosis of lesions in young children, especially in the case of apical fractures of the nail phalanges and lesions of the growth plate. The following methods are used to confirm the diagnosis:

• X-ray of a finger. The basic technique that allows you to determine the majority of fractures. Pictures are taken in two projections. On radiographs, a fracture line, the number and direction of displacement of fragments are visible.
• CT finger. It is prescribed for insufficient information content of the baseline study. Allows you to get a three-dimensional image of the damaged phalanx, confirm the presence and clarify the location of the fracture.
• Finger MRI. It is required in doubtful cases in children of a younger age group and if a growth plate injury is suspected. Well visualizes cartilaginous tissue, which is practically not visible on conventional radiographs.

Finger fractures in children are differentiated with bruises. In favor of a bruise, a mildly pronounced edema, the absence of deformation and soreness with pressure along the axis testify.

Treatment of a broken finger in a child

Conservative therapy

Treatment is often conservative. In case of injuries without displacement, the fingers of the hand are fixed with a plaster splint for a period of 7-10 days. For patients with lesions of the index, middle and ring fingers, a plaster boat is applied along the palmar surface, the little fingers are immobilized with a splint along the lateral surface, the thumb is plastered separately from the rest.

In case of toe injuries, dynamic splinting is performed by bandaging the diseased toe to the neighboring healthy one. For children with a fracture of the big toe, it is recommended to apply a cast even in the absence of displacement. In case of displacement, reposition is preliminarily performed, the hand or foot is fixed with a plaster cast.

Comparison of fragments can be associated with significant difficulties due to the small size of children’s phalanges. In difficult cases, percutaneous fixation with a needle is performed; in young children, an injection needle is used. The child is sent for control radiography, with satisfactory results, immobilization is continued for 2 weeks. Then physiotherapy exercises are prescribed.

Surgical treatment

Surgical interventions are indicated for open injuries with soft tissue defects. Apply various options for skin plastics. Small wounds are closed with a local skin flap. A skin graft taken from the inside of the forearm is used to eliminate the defect in the flap cutting area. The flaps are pressed down with a gauze ball to improve contact with the underlying tissues and increase the likelihood of engraftment.

Large wounds are closed with a pedicled flap with a base in the area of ​​the palmar surface of the hand. The leg is cut off 3 weeks after the operation. The duration of immobilization after interventions to replace a soft tissue defect in open fractures ranges from 2 to 3 or more weeks, depending on the chosen technique, the severity of the injury, and the success of the healing of the flap. In the recovery period, physiotherapeutic procedures are carried out, exercise therapy is prescribed.

Forecast

The prognosis for most children is favorable. Fractures of the fingers and toes heal well, movements are preserved in full, and there are no residual deformities. An unfavorable outcome is possible in the presence of displacement or open damage and late seeking medical help – in such cases, difficulties arise during reposition, early plasty becomes impossible due to infection of the wound.

Prophylaxis

Prevention of finger fractures in young children involves constant monitoring by parents, providing a safe space within the apartment, a careful choice of conditions for walking and outdoor games. Middle-aged and older children should be taught the basics of safe behavior at home and on the street. Working with tools should be done under the supervision of parents and after appropriate training. Classes in sports sections should be carried out under the guidance of a coach and using special equipment.