How long does a broken toe take to heal. What are the symptoms of a broken toe. How to care for a broken toe at home. When to seek medical attention for a broken toe. What to expect during broken toe recovery.

Understanding Broken Toes: Causes and Types

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 essential to understand the different types of fractures and when medical attention is necessary.

There are two main categories of broken toes:

• Simple fractures: These are clean breaks that don’t involve displacement of the bone.
• Compound fractures: These are more severe and may involve an open wound or displaced bone fragments.

When to Seek Medical Help

While many broken toes can be managed at home, certain situations require professional medical attention. These include:

• Severe pain that doesn’t improve with home remedies
• Open wounds or visible bone
• Significant deformity or misalignment of the toe
• Injuries involving the big toe
• Numbness or tingling in the affected toe

Symptoms and Diagnosis of a Broken Toe

Recognizing the symptoms of a broken toe is crucial for proper treatment and recovery. Common signs include:

• Pain, especially when bearing weight
• Swelling around the affected area
• Bruising that may last up to two weeks
• Stiffness and difficulty moving the toe
• Visible deformity in severe cases

How is a broken toe diagnosed? In most cases, a physical examination and description of the injury are sufficient for diagnosis. However, for more severe injuries or when complications are suspected, imaging tests such as X-rays may be necessary to determine the extent of the fracture and guide treatment.

Initial Treatment and Pain Management

The first 24 to 48 hours after a toe injury are crucial for managing pain and reducing swelling. Follow these steps for immediate care:

1. Rest: Avoid putting weight on the injured foot and limit physical activity.
2. Ice: Apply ice to the affected area for 20 minutes every hour while awake, then 2-3 times daily.
3. Elevation: Keep the foot elevated above heart level to minimize swelling.
4. Compression: Gently wrap the toe with an elastic bandage to reduce swelling.

Pain Relief Options

What are the best pain relief options for a broken toe? Over-the-counter pain medications can help manage discomfort:

• Ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn) for pain and inflammation
• Acetaminophen (Tylenol) for pain relief

Always follow the recommended dosage and consult a healthcare provider if you have any underlying health conditions or are taking other medications.

Home Care Techniques for Broken Toes

Proper home care is essential for the healing process of a broken toe. Here are some techniques to promote recovery:

Buddy Taping

Buddy taping is a common method to stabilize a broken toe. How is buddy taping done?

1. Clean and dry the affected toe and the adjacent toe.
2. Place a small piece of cotton or gauze between the toes to prevent moisture buildup.
3. Wrap medical tape around both toes, starting at the base and working towards the tip.
4. Ensure the tape is snug but not too tight to allow for proper circulation.
5. Change the tape and cotton daily or if it becomes wet or dirty.

Appropriate Footwear

Choosing the right footwear is crucial for protecting the injured toe and promoting healing. Consider the following options:

• Open-toed sandals or shoes to accommodate swelling
• Stiff-soled shoes to minimize toe movement
• Orthopedic shoes or boots prescribed by a healthcare provider for more severe injuries

Recovery Timeline and Expectations

Understanding the typical recovery timeline for a broken toe can help manage expectations and ensure proper healing. How long does it take for a broken toe to heal completely?

The healing process generally follows this timeline:

• 0-2 weeks: Initial pain and swelling subside
• 2-4 weeks: Bone begins to heal, and mobility improves
• 4-6 weeks: Most broken toes heal completely
• 6-8 weeks: Full recovery for more severe injuries or those requiring surgery

It’s important to note that individual healing times may vary based on factors such as age, overall health, and the severity of the injury.

Gradual Return to Activity

As the broken toe heals, it’s essential to gradually reintroduce normal activities. How should one approach returning to physical activity after a broken toe?

1. Start with gentle range-of-motion exercises as pain allows.
2. Gradually increase weight-bearing activities, using pain as a guide.
3. Incorporate low-impact activities like swimming or stationary cycling before returning to high-impact exercises.
4. Listen to your body and avoid pushing too hard too soon.

If pain or swelling increases during activity, it’s important to rest and ice the affected area. Consult a healthcare provider if symptoms persist or worsen.

Potential Complications and When to Seek Further Medical Care

While most broken toes heal without complications, it’s essential to be aware of potential issues that may arise during the recovery process. What are some complications to watch out for?

• Chronic pain or stiffness
• Malunion (improper healing of the bone)
• Arthritis in the affected joint
• Infection, especially in cases of open fractures

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

• Increased pain, swelling, or redness
• Fever or signs of infection
• Numbness or tingling in the toe
• Difficulty walking or bearing weight after the initial recovery period
• Persistent deformity of the toe

Long-Term Care and Prevention of Future Injuries

After recovering from a broken toe, it’s important to take steps to prevent future injuries and maintain foot health. How can one protect their toes from future fractures?

• Wear properly fitting shoes with adequate toe room
• Use protective footwear in high-risk environments, such as construction sites
• Practice proper foot care, including regular stretching and strengthening exercises
• Be mindful of potential hazards in your environment to avoid accidents

Additionally, maintaining overall bone health through a balanced diet rich in calcium and vitamin D, regular weight-bearing exercises, and avoiding smoking can help reduce the risk of future fractures.

Ongoing Foot Care

Proper foot care is essential for long-term health and prevention of future injuries. Consider the following tips:

• Regularly inspect your feet for any signs of injury or abnormalities
• Keep toenails trimmed and feet clean to prevent infections
• Use moisturizer to prevent dry, cracked skin
• Rotate your shoes to allow them to dry completely between uses
• Consider custom orthotics if you have structural foot issues

By following these guidelines and remaining attentive to your foot health, you can minimize the risk of future toe injuries and maintain overall foot function.

Alternative Therapies and Complementary Treatments

While traditional medical approaches are the primary means of treating broken toes, some individuals may find benefit in complementary therapies. What alternative treatments might help with broken toe recovery?

• Acupuncture: May help with pain management and promote healing
• Herbal remedies: Some herbs, such as arnica or comfrey, are believed to have anti-inflammatory properties
• Homeopathy: Certain homeopathic remedies may support the healing process
• Vitamin and mineral supplements: Nutrients like vitamin C, zinc, and calcium can support bone health

It’s important to note that while these alternative therapies may offer some benefits, they should not replace conventional medical treatment. Always consult with a healthcare provider before incorporating any new treatments into your recovery plan.

Physical Therapy for Broken Toes

In some cases, particularly for more severe injuries or those involving the big toe, physical therapy may be recommended as part of the recovery process. How can physical therapy benefit broken toe recovery?

• Improve range of motion and flexibility
• Strengthen muscles supporting the toe and foot
• Enhance balance and coordination
• Provide guidance on proper gait and walking techniques
• Offer strategies for pain management and swelling reduction

A physical therapist can develop a customized treatment plan tailored to your specific injury and recovery needs, helping to ensure optimal healing and a return to full function.

Emotional and Psychological Aspects of Recovery

While the physical aspects of a broken toe are often the primary focus, it’s important to acknowledge the emotional and psychological impact of such an injury. How can a broken toe affect mental well-being?

• Frustration with limited mobility and independence
• Anxiety about the healing process and potential complications
• Depression due to inability to participate in regular activities
• Stress related to missed work or financial concerns

To address these emotional challenges, consider the following strategies:

1. Practice stress-reduction techniques such as deep breathing or meditation
2. Engage in hobbies or activities that don’t require foot involvement
3. Maintain social connections through phone calls, video chats, or visits from friends and family
4. Seek support from a mental health professional if feelings of anxiety or depression persist

Remember that healing involves both physical and emotional aspects, and addressing both can lead to a more complete and satisfying recovery.

Adapting Daily Activities During Recovery

Recovering from a broken toe often requires adjustments to daily routines and activities. How can one modify their lifestyle to accommodate a healing toe?

• Use assistive devices like crutches or a cane for balance and support
• Rearrange living spaces to minimize the need for walking or climbing stairs
• Utilize delivery services for groceries and other essentials
• Explore seated exercise options to maintain overall fitness
• Adjust work responsibilities or explore work-from-home options if possible

By making these adaptations, you can promote healing while maintaining as much independence and normalcy as possible during the recovery period.

Hygiene and Self-Care Considerations

Maintaining proper hygiene can be challenging with a broken toe. What strategies can help manage personal care during recovery?

• Use a shower chair or stool to avoid putting weight on the affected foot
• Wrap the injured toe in a waterproof covering during bathing
• Consider using a long-handled sponge or washcloth for hard-to-reach areas
• Opt for slip-on shoes or adaptive footwear to make dressing easier
• Use a reacher or grabber tool to pick up items from the floor

These adaptations can help maintain independence and reduce the risk of further injury during daily self-care routines.

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.

How to tell if a finger is broken – Article

Step-by-step instructions on how to check for a broken finger:
1. Pay attention to pain and hypersensitivity. The first sign of a broken finger is pain. The intensity of the pain depends on the severity of the fracture. Be careful with your finger after injury and pay attention to the degree of pain first.

• It can be difficult to tell if a finger is broken at first, as the sharp pain and tenderness are also accompanied by dislocations and sprains.
• Look for other symptoms or seek medical attention if you are unsure of the severity of your injury.

2. Pay attention to swelling and bruising. A fracture of the finger is accompanied by acute pain, after which there is swelling or bruising. This is the body’s natural response to injury. After a fracture, an inflammatory process is activated in the body, which leads to edema as a result of the release of fluid into the surrounding tissues.

• A bruise often follows the swelling. This happens when the small blood vessels surrounding the fracture swell or burst due to increased fluid pressure.
• It can be difficult at first to tell if a finger is broken if you are still able to move it. However, after you move your finger, the swelling and bruising will become more noticeable. The swelling may also spread to adjacent fingers or to the palm of the hand.
• As a rule, swelling and bruising appear 5-10 minutes after the first attacks of pain in the finger.
• However, slight swelling may also occur due to stretching. However, it is not accompanied by immediate bruising.

3. Look at the deformity of the finger and the inability to move it. In this case, the phalanx of the finger cracks or breaks in one or more places. The deformity of the bone may show up as unusual bulges on the finger or a twist in the finger.

• If the finger is unusually crooked, it is a sign of a fracture.
• Usually, a broken finger cannot be moved due to the fact that the connection between the phalanges is broken.
• A fracture may be accompanied by so much swelling and bruising that it will be difficult for you to move your finger.

4. Know when to seek medical attention. If you suspect you have a broken finger, go to the nearest emergency room or emergency room. A bone fracture is a serious injury, the severity of which can not always be assessed only by external symptoms. Some fractures require special measures for the bone to heal properly. If there is a suspicion that you have a fracture, it is better to play it safe and consult a doctor.

• Seek medical attention if your finger is in severe pain, swelling, bruising, or any other deformity.
• In case of finger injuries in children, always seek medical attention. Young and growing children’s bones are more prone to injury, as well as complications in case of improper treatment of fractures.
• In the absence of professional treatment of a fracture, the finger and palm may partially lose their mobility.
• Failure to properly realign a broken bone can limit your ability to use your palm.

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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 the 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.