Fractured baby toe healing time: Treatment, Recovery Time, Signs & Pictures
Symptoms, treatment, and other conditions
A broken pinky toe is a fracture of the smallest toe. The term “broken toe” usually describes a traumatic fracture, which can occur due to a direct blow or impact, such as stubbing the toe or dropping something on it.
The pinky toe is a commonly broken toe, and the fracture usually occurs at its base.
This article looks at the symptoms of a broken small toe, along with some other problems that can cause pain and swelling in the area. It also examines the treatment and management options for this injury.
The most common symptoms of a broken pinky toe include:
- a snapping, grinding, or popping noise at the time of the break
- pain at the place of impact at the time the fracture occurs
- the toe appearing to be crooked
- redness, bruising, and swelling
If there is an open wound, a person should seek immediate medical attention to prevent infection.
Other than a broken pinky toe, there are many reasons a person might have pain or swelling in their smallest toe.
People can treat most of these causes at home. However, if home remedies do not seem to be working, it is important to see a doctor, as the issue could turn out to be something more serious.
The following sections outline some other causes of pain and swelling in the pinky toe in more detail.
A stress fracture, or a hairline fracture, is a small crack or severe bruising within a bone.
It is slightly different from a traumatic fracture, as it usually occurs due to overuse and repetitive activity.
- pain during or after performing normal activities
- pain that goes away when resting but returns when standing or during activity
- painful to the touch
- swelling but no bruising
According to the American Academy of Orthopaedic Surgeons (AAOS), the most important treatment for a stress fracture is rest.
Advising that it takes up to 8 weeks for most fractures to heal, the AAOS warn against resuming the activity that caused the stress fracture to occur too quickly. They warn that this could lead to long-term problems.
As well as resting, using shoe inserts or braces can help stress fractures heal.
Learn more about stress fractures here.
A sprain occurs when there is damage to a ligament. Ligaments are the bands of tough, elastic connective tissue that connect the bones in the toes to each other.
- difficulty walking
- tender to the touch
The AAOS categorize sprains into three grades:
- Grade I: This is characterized by overstretched ligaments, a minimal loss of function, and mild pain.
- Grade II: This is characterized by a partially torn ligament, moderate pain, and difficulty putting weight on the toe.
- Grade III: This is characterized by a complete tear of the ligament, severe pain, a total loss of function, and an inability to bear weight.
Treatment depends on the severity of the sprain but could include:
- resting the toe
- icing the toe
- wearing a compression sock
- using crutches to aid walking
- taking pain relief medication
- using a walking boot, which is a stiff boot that protects the toe as it heals
Learn about the difference between a sprain and a strain here.
A dislocation is a complete separation of the bones in a joint. The bones then move out of their normal position.
- severe pain
- deformity or displacement of the toe
- swelling and bruising
- numbness or tingling
- difficulty moving the toe
- “buddy” taping it to an adjacent toe
- using a splint
- wearing a cast
- trying a walking boot
A bunion is a painful, bony bump on the toe joint.
A bunion on the pinky toe is called a tailor’s bunion. Historically, this name comes from the tailors who sat cross-legged all day, with the outside edge of their feet rubbing on hard surfaces.
- a visible bump on the outside of the pinky toe
- pain and tenderness at the site of the bump
- redness and inflammation
- a callus or corn on the bump
In some cases, corticosteroid injections can help treat the inflamed tissue around the joint. Surgery may be necessary in severe cases.
Learn more about tailor’s bunions here.
Corns are hard, thickened areas of skin that form as a result of friction or pressure. Corns are the foot’s natural defense to help protect the skin underneath them. They are a response to bone pressure against the skin.
Corns may develop on the tops and sides of the toes and on the balls of the feet.
- a hardened patch of skin
- open sores between the toes
- pain when wearing shoes
- shaving the corn, but only when a health professional carries it out
- soaking the feet and using a pumice stone on the corn
- wearing a donut shaped foam pad over the corn to reduce the pressure
Learn more about corn remedies here.
It is best to visit a doctor as soon as someone suspects that there is something wrong. This is particularly important if a person hears a snapping, grinding, or popping noise at the time of the break.
If a person leaves a broken toe untreated, it can get worse and cause lasting problems.
The doctor will examine the foot, gently pressing on different areas to find out where there is pain.
They will also order X-rays. Additional imaging studies may be necessary if the initial X-ray does not show anything.
It is a myth that nothing can mend broken toes. In fact, leaving them without treatment can lead to future complications.
Healing of a broken toe may take 6–8 weeks.
A person may need to have their broken toe buddy taped to an adjacent one. Wearing a stiff-soled shoe can also help, as can using crutches to help keep weight off of the toe while it heals.
Rarely, a person may need to wear a cast to keep the foot immobile.
Surgery may be necessary if there are multiple breaks or if nonsurgical treatment does not work.
Also, if a fracture leads to large amounts of blood underneath the nail, a person may need to take antibiotics and undergo nail removal.
Taking NSAIDs such as aspirin and ibuprofen can help decrease swelling and pain.
At home, people can use the RICE method to try to reduce swelling and allow the pinky toe to heal.
- Rest: Give the toe time to heal.
- Ice: Ice the toe for up to 20 minutes four times per day.
- Compression: Using an elastic bandage or brace can provide support and reduce swelling.
- Elevate: Elevating the foot above the heart can also help reduce swelling.
Learn more about the RICE method here.
The pinky toe works with the rest of the toes to keep a person balanced. A person’s foot works in a tripod fashion to keep them balanced, with the little toe being one part, the big toe another, and the heel the third.
Sustaining damage to any part of this tripod can affect a person’s range of motion.
Learn more about the bones of the feet here.
It might be small, but the pinky toe plays a vital role in keeping a person balanced. Therefore, any damage to it can cause issues.
It is important to seek medical attention if a person suspects a broken toe, as it can get worse without treatment.
A person can treat milder problems at home, by changing their footwear, taking NSAIDs, and resting. A medical team can treat more serious issues.
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.
- Immediate complications
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.
- 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.
- 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.
- 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.
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.
- 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.
- 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.
- 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.
To help prevent an injury resulting in a broken toe, sturdy and supportive shoes should be worn.
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
American Academy of Orthopaedic Surgeons (AAOS)
9400 W. Higgins Road
Rosemont, IL 60018
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
Toe Fracture | UVA Health
What Is a Toe Fracture?
A toe fracture is a break in a toe bone. The bones in the toes are called phalanges.
How Can You Fracture Your Toe?
A toe fracture is caused by trauma to the bone. Trauma can result from:
- Dropping something on your toe
- Stubbing your toe
- Falling down
- Direct blow to the toe
Copyright © Nucleus Medical Media, Inc.
Risks of Getting a Fractured Toe
Factors that may increase your risk of a toe fracture include:
- Advanced age
- Poor nutrition
- Participating in contact sports
- Not wearing shoes
Toe Fracture Symptoms
A toe fracture may cause:
- Swelling and tenderness
- Stiffness in the injured area
- Inability to move toe
- Bruising in injured area
- Numbness or tingling in the toes
- Visible deformity in the toe area
- Difficulty walking (sometimes)
Diagnosing Toe Fractures
The doctor will ask about your symptoms, level of physical activity, how the injury occurred, and will examine the injured area. Your doctor may take an x-ray of the foot, but this is not always needed.
Treating Toe Fractures at UVA
Proper treatment can prevent long-term complications or problems with your toe, such as immobility or misalignment. Treatment will depend on how serious the fracture is, but may include:
Extra support may be needed to protect, support, and keep your toe in line while it heals. Supportive steps may include buddy taping (your injured toe is taped to healthy toes next to it), a walking cast, or stiff bottom shoe.
Some fractures cause pieces of bone to separate. Your doctor will need to put these pieces back into their proper place. This may be done:
- Without surgery — you will have anesthesia to decrease pain while the doctor moves the pieces back into place
- With surgery — pins or screws may be needed to reconnect the pieces and hold them in place
Children’s bones are still growing at an area of the bone called the growth plate. If the fracture affected the growth plate, your child may need to see a specialist. Injuries to the growth plate will need to be monitored to make sure the bone can continue to grow as expected.
Prescription or over-the-counter medications may be given to help reduce inflammation and pain.
Medications may include acetaminophen or ibuprofen.
Check with your doctor before taking nonsteroidal anti-inflammatory medications, such as ibuprofen or aspirin.
Note: Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving your child aspirin.
Rest and Recovery
Healing time varies by age and your overall health. Children and people in better overall health heal faster. In general, it takes up to 6-8 weeks for a fractured toe to heal.
You will need to adjust your activities while your toe heals, but complete rest is rarely required. Ice and elevating the leg at rest may also be recommended to help with discomfort and swelling.
Do not return to activities or sports until your doctor gives you permission to do so.
If you have a fractured toe, follow your doctor’s instructions .
Preventing Toe Fractures
To help reduce your chance of toe fractures, take these steps:
- Do not put yourself at risk for trauma to the bone.
- Wear proper fitting and appropriate shoes for any activity.
- Wear proper padding and safety equipment when participating in sports or activities.
- Do weight-bearing and strengthening exercises regularly to build strong bones.
To help reduce falling hazards at work and home, take these steps:
- Clean spills and slippery areas right away.
- Remove tripping hazards such as loose cords, rugs, and clutter.
- Use non-slip mats in the bathtub and shower.
- Install grab bars next to the toilet and in the shower or tub.
- Put in handrails on both sides of stairways.
- Walk only in well-lit rooms, stairs, and halls.
- Keep flashlights on hand in case of a power outage.
Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.
Toe Injury in Kids | Children’s Hospital Colorado
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.
- 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.
Broken Foot or Toes (Forefoot & Toe Fractures)
What Is a Broken Foot or Broken Toes?
Nearly one-fourth of all the bones in your body are in your feet, which provide you with both support and movement. A broken (fractured) bone in your forefoot (metatarsals) or in one of your toes (phalanges) often is painful but rarely disabling. Most
of the time, these injuries heal without surgery. Since a dislocation can be mistaken for a toe fracture, it is important to obtain X-rays to ensure a correct diagnosis.
Pain, swelling, and bruising are the most common signs of a fracture in the foot. If you have a broken toe, you may be able to walk but this usually aggravates the pain. If the pain, swelling, and discoloration continue for more than 2-3 days, or if pain
interferes with walking, something could be seriously wrong; see your foot and ankle orthopaedic surgeon as soon as possible. If you delay getting treatment, you could develop persistent foot pain and arthritis.
Pain also can change the way you walk (your gait), which could lead to painful calluses on the bottom of your foot or other issues.
Stress fractures frequently occur in the bones that extend from your toes to the middle of
your foot (metatarsals). Stress fractures are like tiny cracks in the bone surface. They can occur with sudden increases in physical activity, such as running or walking for longer distances or times, improper training techniques, or changes in training
surfaces. They may be related to the shape of the foot, an overly tight calf muscle or heel cord (Achilles), or metabolic or nutritional factors.
Traumatic fractures result from a sudden force, such as a fall, dropping a heavy object on your foot, or a twisting injury. If the fractured bone does not break through the skin, it is called a closed fracture. These fractures may be stable with no shift
in bone alignment or displaced with bone ends that no longer line up.
Several types of fractures can occur to the forefoot bone on the side of the little toe (fifth metatarsal). Ballet dancers may break this bone during a misstep or fall from a pointe position. An ankle-twisting injury may tear the tendon that attaches
to this bone and pull a small piece of the bone away. A more serious injury in the same area is a Jones fracture,
which occurs near the base of the bone and disrupts the blood supply to the bone. This injury may take longer to heal or require surgery.
Your foot and ankle orthopaedic surgeon will examine your foot to pinpoint the central area of tenderness and compare the injured foot to the normal foot. You should tell your surgeon when the pain started, what you were doing at the time, and if there
was any injury to the foot. X-rays will show most fractures of the forefoot and should be obtained standing if possible to improve diagnostic accuracy. A CT scan or MRI may be needed if the fracture enters a joint, or if X-rays fail to reveal an injury.
See your foot and ankle orthopaedic surgeon as soon as possible if you think that you have a broken bone in your foot or toe. Until your appointment, keep weight off the painful area and apply ice to reduce swelling. Use an ice pack or wrap the ice in
a towel so it does not come into direct contact with the skin. Apply the ice for no more than 20 minutes at a time. Take acetaminophen or ibuprofen to help relieve the pain. Wear a wider shoe with a stiff sole to remove stress from the injury site.
Rest is the primary treatment for stress fractures in the foot. Stay away from the activity that triggered the injury, or any activity that causes pain at the fracture site, for 3-4 weeks. Substitute another activity that puts less pressure on the foot,
such as swimming. Gradually, you will be able to return to activity. Your surgeon, physical therapist, or coach may be able to help you pinpoint the training errors that caused the initial problem so you can avoid a recurrence.
If you have a displaced fracture, the bone ends must be realigned and the bone kept immobile until healed. If you have a broken toe, the doctor will “buddy tape” the broken toe to an adjacent toe, with a gauze pad between the toes to absorb moisture.
You should replace the gauze and tape as often as needed. Remove or replace the tape if swelling increases and the toes feel numb or look pale. If you have diabetes with neuropathy or peripheral neuropathy (loss of sensation in the toes), do not tape
the toes together. You may need to wear a rigid, flat-bottom orthopaedic shoe for several weeks.
If you have a broken bone in your forefoot, you may have to wear a short-leg walking cast, a brace or a rigid, flat-bottom shoe. It could take 6-8 weeks for the bone to heal, depending on the location and extent of the injury. After a week or so, your
foot and ankle orthopaedic surgeon may request another set of X-rays to ensure that the bones remain properly aligned. Many of these fractures are treated successfully without surgery, although in severe injuries, pins or screws may be required to
hold the bones in place while they heal. Surgery often is not needed to treat fractures in the toes or forefoot. However, when it is necessary, it has a high degree of success.
The forefoot and toes tend to heal slowly, so it can take months for a fracture to heal. In the toes, swelling can continue for a long time even when patients are not having other symptoms.
Risks and Complications
Risks associated with these fractures are specific to the injury. If the fracture goes into a joint, it could lead to arthritis. If the skin is broken at the time of the injury, you could develop an infection.
On occasion, the bone does not heal. In other cases, pain or swelling can remain. For these reasons, it is important to have further follow up with your surgeon if you continue to have symptoms.
Last reviewed by Jeff Feinblatt, MD, 2018
The American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site as an educational service. The content of FootCareMD, including text, images, and graphics, is for informational purposes only. The content is not intended to substitute
for professional medical advice, diagnoses or treatments. If you need medical advice, use the “Find a Surgeon” search to locate a foot and ankle orthopaedic surgeon in your area.
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.
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.)
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.
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 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
Fracture of the leg
You have a broken leg. The fracture is treated with a splint, plaster cast, or a special shoe. The fracture will take 4 to 6 weeks to heal. If you have a severe fracture, you may need surgery to heal it.
When treating at home, observe the following recommendations:
You will be given a splint or plaster cast, a special shoe or other device will be used to fix your leg.Use crutches or a walker when walking unless you are instructed otherwise. Do not step on an injured foot until you have received permission from your healthcare professional to do so. (You can rent crutches or walkers at many drug stores or surgical or orthopedic stores.)
Keep your leg elevated to reduce pain and swelling. Place a pillow under your injured leg when you go to bed. When sitting, place your injured leg so that it is at waist level.It is very important to follow this rule during the first 2 days (48 hours).
Place an ice pack on the injury site. Apply an ice pack for 20 minutes every 1 to 2 hours for the first day to reduce pain. You can make an ice pack by wrapping a plastic bag with ice cubes in a thin towel. Make sure that the gypsum / splint / boot does not get wet when the ice melts. You can apply an ice pack directly over a splint or cast. For the next 2 days, continue to apply the ice pack 3-4 times a day.Then use an ice pack as needed to reduce pain and swelling.
The cast / splint / boot must always be kept dry. Do not immerse the cast / splint / boot in water while washing. To prevent water ingress, wrap the bandage in a plastic bag, securing it at the top with rubber tape. If your boot, fiberglass tire or splint gets wet, you can blow dry it.
If you have not been prescribed other drugs, you can take acetaminophen or ibuprofen to relieve pain.If you have chronic liver disease or chronic kidney disease, consult your healthcare professional before using these drugs. You should also consult your doctor if you have had a stomach ulcer or GI bleeding.
If you experience itching, do not apply any creams or objects under the cast.
Visit your doctor again after 1 week or as directed.This is to make sure the bone is healing properly. If a splint was applied, at the next visit to the doctor, it can be replaced with a plaster cast.
If X-rays have been taken, the radiologist will review them. You will be told about any results that may affect your treatment.
When to seek medical attention
If any of the following occurs, contact your healthcare provider immediately:
A crack appears in the dressing
The cast or splint is wet or soft
FRP splint or the splint remains damp for more than 24 hours
The bandage smells unpleasant, or the bandage has stains from wound discharge
Feeling of tightness or pain under the plaster cast or splint increases
Toes swell and become cold blue, numb, or tingling
You cannot move your toes
The skin around the dressing turns red
Temperature 101 ºF (38.3 ºC) or higher, or as directed by your healthcare provider doctor
severe pain in the area of injury;
limitation of movement in adjacent joints;
sometimes visible deformity of the bone;
inability to step on the foot;
- pathological mobility;
- Functional impairment.
- ineffectiveness of conservative treatment;
90,035 90,000 symptoms, diagnosis, treatment at the Central Clinical Hospital of the Russian Academy of Sciences
Fractures of the phalanges of the fingers occur both with a direct mechanism of injury – a fall, blow to the finger, and with an indirect mechanism – for example, as a result of forced rotational movements (twisting) of the finger.Depending on this, the types of fractures of the phalanges of the fingers are distinguished – oblique, comminuted, transverse, helical. The approaches to the treatment of these fractures are somewhat different from each other.
With a fracture, acute pain is felt, deformity of the finger may occur, and edema appears.
The average period of fusion of the phalanges of the fingers is about 3-4 weeks.
Treatment of fractures of the phalanges of the fingers
Fractures of the phalanges of the fingers with little or no displacement are treated with a plaster cast for 3-4 weeks.When displaced, to ensure movement in the joints of the fingers, surgical treatment is performed – osteosynthesis (fixation of fragments). This helps to avoid the formation of joint stiffness (contractures), which in the most advanced cases can lead to the formation of ankylosis (complete absence of movement in the joint).
For fractures with displacement of fragments, their fixation is usually required – possible options: fixation with wires through skin punctures (the wires remain protruding above the skin), a plate and / or screws that are installed through the incision.When the braces are installed, movements in the joints of the finger can be developed a few days after the operation.
In case of fractures of the base or head of the phalanx, fixation is usually carried out with pins or screws, for fractures of the diaphysis – with screws or a plate. For multi-splinter fractures of the phalanges of the fingers, an external fixation device can be installed.
A plaster cast after surgery, as a rule, is not applied. The exception is severe unstable comminuted fractures.
The average hospital stay is about 5 days.
The final choice of the method of osteosynthesis remains with the attending physician, based on medical indications, the nature of the displacement of fragments, functional requirements for the hand.
Fracture of the leg | EMC
Fracture is a bone injury with a violation of its integrity. A leg fracture can occur as a result of a fall, a strong impact, overuse, and affect any part of the lower limb.
In case of a fracture or suspicion of a fracture, it is necessary to immediately consult a doctor in order to start treatment on time, to avoid possible complications and to shorten the recovery period.
Types of fractures
By the nature of the location of the fragments, fractures with and without displacement are distinguished. The type of displacement depends on the direction of the traumatic force, as well as the traction of the muscles that are attached to a particular site of the bone.
In addition, there are closed and open fractures.With a closed fracture, the integrity of the skin is not violated, while an open fracture is accompanied by skin damage and the formation of an open wound. In almost all cases, an open fracture requires emergency surgery.
In addition, there are simple (the formation of 2 bone fragments), comminuted (the formation of 3 or more bone fragments) and multiple (fracture of different bones on one limb) fractures.
Causes of fractures:
Symptoms of fractures:
Swelling often occurs after a fracture.This is due to impaired blood flow in the area of injury, however, sometimes damage to muscle tissue can be the cause. Edema can occur both immediately after injury and long after it.
A preliminary diagnosis can be established during a clinical examination by a specialist of the site of injury, however, to clarify the diagnosis, it is necessary to conduct an X-ray study, which allows you to determine the exact location and nature of the fracture.If the fracture line passes through the joint, a CT scan is needed.
The round-the-clock diagnostic department of the European Clinic of Sports Traumatology and Orthopedics (ECSTO) is equipped with the most modern equipment that allows you to accurately and quickly diagnose and immediately begin treatment.
Treatment of a broken leg
Depending on the nature, type of fracture and age of the patient, conservative or surgical treatment is used.In the first case, the injured limb is immobilized with a longitudinal bandage until the edema subsides, then a final plaster or plastic (polymer) bandage is applied.
The duration of the final dressing depends on many factors, including the location and severity of the fracture, and can range from 1 to 4 months
Treatment of fractures with a surgical method (osteosynthesis) is carried out, as a rule, in complex cases (open, comminuted fractures, fractures with displacement). Fractures without displacement are also operated if there is a high risk of its occurrence.To fix the fragments, various metal structures (plates, pins) are used, which allow the bone to be fixed in the correct anatomical position, not to use external immobilization, and to start early rehabilitation. After the fracture has healed (healed), metal fixators in most cases do not require removal, but sometimes they can be removed for medical reasons or at the request of the patient.
Rehabilitation after a broken leg
If swelling occurs after removing the final dressing, the doctor may recommend the use of ointments, physiotherapy, and therapeutic exercises.We do not recommend trying to get rid of edema using folk methods. Competent treatment, suitable in a particular case, can only be prescribed by a qualified specialist.
Fracture recovery can be done at the ECSTO Rehabilitation Department. Here is a full range of procedures, techniques and devices that allow the patient to return to their normal life in the shortest possible time.
As a rule, the recovery time after a fracture of the lower extremity ranges from one to several months.
90,000 Symptoms and principles of treatment of limb fractures using traditional medicine
Fractures of the arms and legs – general principles for the treatment of limb fractures
In the statistics of serious injuries, fractures of the arms and legs rank first. And this is not surprising, because these parts are more mobile and are more used in a given situation. Falls are the most common cause of injury in winter.The tactics of treating limb fractures directly depends on many factors, and the consequences of this type of injury depend on the fulfillment of medical prescriptions.
Signs of limb fracture
Most of these injuries manifest themselves in the same way:
Pain and dysfunction occur immediately at the time of injury.Pain may be mild at first, even with significant damage. This is due to the release of endorphins – natural analgesic substances. After a short time, their number decreases and the pain becomes maximum.
The edema increases gradually. Initially, it is localized only at the point of impact (if it was inflicted), but later spreads above and below the site of injury.
Pathological mobility appears with a complete fracture of the bone body. In this case, the bone fragments are displaced relative to each other at the fracture site.
Deformation is noted in cases of displacement of parts of the broken bone from the normal axis.
Signs of fracture of the bones of the hands
The hands are composed of 27 bones. Among the carpal bones, the scaphoid is most often affected, less often the lunate. The symptoms of a hand fracture are pain, swelling, and dysfunction.
With injuries to the metacarpal bones and fingers, which account for 2.5% and 5% of all fractures, all these signs are noted.
Symptoms of fracture of the bones of the shoulder and forearm
The most common is the so-called fracture of the radius of the typical localization.This bone has one place that most often breaks when falling onto an outstretched arm. The shoulder bones can also be damaged when falling on a hand, even if it is pressed against the body. All the described signs of a fracture are inherent in this localization.
Fractures of the thigh, lower leg
These fractures occur as a result of excessive axial load, blows to the thigh and lower leg, car accidents, and in old people – from falling to the side (this is how the femoral neck breaks). Symptoms of damage to this localization are quite diverse.For cervical hip fractures, the turn of the foot outward and the inability to lift the extended leg upward is characteristic. With fractures of the fibula, the main symptom is pain (the supporting function is not impaired), with trauma to the tibia, displacement often occurs due to the peculiarities of the attachment of muscles to it. Swelling of the leg after a fracture of the leg is also very common. Moreover, due to the compression of the vessels, it can persist for quite a long time even after the veins are released from the bone fragment pressing on them.
The most common of all fractures of the bones of the lower extremities are various fractures of the ankles. They usually occur when the leg is twisted and all your weight is transferred to it. Less commonly, the ankles suffer from a direct blow. Composing the ankle joint, they perform a supporting function, therefore, when they are fractured, a person’s ability to step on the injured leg drops sharply. The pain of a fracture of the ankle is very strong, it is she who makes the victim to spare the site of injury.
Fractures of the bones of the foot
Pain is the most common symptom for this type of injury. In case of damage to the bones of the tarsus (calcaneus, talus, etc.), the support function of the foot is also impaired. With injuries to other bones, a person can step on the foot, but spares it.
Fracture of the little toe, which is a symptom of pain, does not impair the support function of the limb. Even if two or more fingers are injured, a person can walk, however, very carefully.
Treatment of limb fractures
Treatment tactics depend on whether the victim’s fracture is open or closed. There are also community principles.
In case of a closed fracture, ensure the rest of the injured limb and immediately apply an immobilizing splint from any available means – a stick, board, piece of plywood or plastic, even from glossy magazines rolled into a tube! You should not try to straighten a broken arm or leg; immobilization is performed in the position in which the limb is immediately after the injury.After immobilization, the victim is taken to the hospital.
First aid for open fractures of the extremities should begin not with immobilization, but with stopping bleeding. To do this, apply a pressure bandage to the wounds, and if it is ineffective, a hemostatic tourniquet, also made from scrap materials – a tie, belt, cord, rope, etc. Only after a reliable stop of bleeding, the limb is immobilized according to the rules described above and the victim is taken to the hospital.
Further treatment of closed fractures is to apply a plaster cast or splints in order to ensure complete immobility of the limb and allow the bones to heal. The immobilization period depends on the severity and location of the fracture. Removal of the cast after ankle fracture is performed after 4-6 weeks, and in case of injuries to the wrist bones – even after 3 months from the moment of injury.
Surgical intervention is performed in the following cases:
90,011 open fractures;
90,011 any fractures with damage to blood vessels and nerves at the site of injury.
Sometimes surgery for fractures of the limbs (upper and lower) may be required, regardless of the presence of complicating factors. For example, most injuries of the femoral neck or oblique fractures of the tibia with displacement of fragments are treated only operatively.
Rehabilitation after limb fractures
The terms of rehabilitation and its tactics after fractures of the extremities depend on the severity of the injury, the method of fracture treatment, and its localization. The timing of the healing of a fracture of the radius of the hand with a displacement usually does not exceed 4 weeks, since the treatment of this type of injury is almost always conservative.A fracture of the femoral neck may generally be incurable due to the peculiarities of the blood supply to the femoral head.
Before removing the cast, a good doctor will take a control X-ray. This is to make sure that the bones are well together. Only after this can the specialist say, for example, when it is possible to step on the leg after a fracture of the bones of the lower limb.
After the removal of the immobilizing agents, the stage of final rehabilitation begins.This word means a set of procedures aimed at restoring the functions of the injured limb – motor, support (for legs), grasping (for hands), etc. However, some exercises begin to be done in the first days after the injury. For example, bedridden patients should perform breathing exercises, and those affected by a fracture of the leg bones should work with a healthy limb so as not to lose mobility in it. Even a sore arm and leg should be moved in dosage – this improves blood supply in it, enhances recovery processes and accelerates bone fusion.Rehabilitation after a fracture in a child is especially important – his arms have not yet fully formed, his legs are still growing. The slightest mistake in treatment will lead to permanent disability.
How to develop an arm after a fracture of the wrist bones, how to get rid of contracture in the ankle joint, how to start walking again, stepping on the leg after a hip fracture – all these questions can be answered by a rehabilitation doctor. To return a person to normal life, physiotherapy exercises, massage, physiotherapy are used.For each type of fracture, special sets of exercises have been developed, which can be read about on the website dobrobut.com.
It is exercise therapy and massage that help when the leg swells after a heel bone fracture. These methods help to improve the elasticity of the ligamentous apparatus of the joints, and only thanks to them, the muscles, weaned from stress during the forced “downtime”, will begin to develop again and perform their functions.
The winter season is a “harvest time” for traumatologists.Trauma is an extremely unpleasant condition that can unsettle any person for a long time, and prevention is the best way to protect yourself from injury. Be prudent, do not go out into the ice without extreme need, look under your feet – and then you do not have to find out how long a fracture of the big toe heals.
Orthopedics and Traumatology
Calling the emergency team
90,000 Rehabilitation after heel fracture – recovery program after plaster cast removal in Moscow
Injury to the heel bone affects the patient’s physical activity and affects the health of not only the foot, but also the entire leg.Decrease in physical activity leads to muscle atrophy, negatively affects blood circulation, metabolism. Therefore, we recommend that you do not limit yourself only to the imposition of a plaster cast, but be sure to consult a doctor who will draw up a program of rehabilitation measures.
Recovery after a heel fracture avoids a large number of complications, including hallux valgus, deformity of the metatarsal bone, degenerative changes in the joint, irritation of the tendons, recurrent pain at the site of injury, the appearance of bone growths, the development of flat feet, osteoporosis, arthritis, etc.
Features of recovery after a fracture of the calcaneus
The rehabilitation program can last up to six months, depending on the severity of the injury, the individual characteristics of the patient (age, weight, physical activity, etc.) and the qualifications of the doctor.
The “Wellbeing” specialist selects recovery methods individually: we do not use “template” solutions, since each case is unique, and only a personal approach allows us to solve the specific problems of each patient as soon as possible.
The rehabilitation program is complex and consists of a number of methods:
- Massage. It can be done even before the doctor removes the plaster cast: the masseur develops the places around the plaster. The main task of the method is to increase blood circulation. At first, the patient may experience discomfort. This is a normal reaction, but it is best to report it to a specialist.
- Physiotherapy exercises. Particular attention is paid to the method if the fracture was displaced. The first simple exercises can be performed after the bone is healed: the patient bends and unbends the fingers, rotates, flexes and unbends the foot, pulls the sock towards and away from himself, walks on toes and heels, rolls the ball with his foot, etc.There should be no severe pain after a fracture of the heel: if the patient feels discomfort, then the training should be interrupted and the doctor should be informed about his condition.
- Physiotherapy. They improve blood circulation, lymph circulation, relieve pain syndrome, inflammation, normalize metabolism, start regeneration processes and promote faster bone and soft tissue recovery. The doctor can prescribe electro- and phonophoresis, laser treatment, UHF, etc.
- Hydrotherapy. Usually, the doctor prescribes warming baths that restore muscle tone and normalize blood circulation.
- Proper nutrition. The diet should contain foods high in calcium, silicon and magnesium.
- Wearing orthoses and orthopedic shoes. Soft, rigid and semi-rigid orthoses reduce swelling and avoid muscle atrophy. And special insoles allow you to correctly distribute the load on the foot, so that it gets less tired. They wear orthopedic shoes for at least six months, the doctor gives precise recommendations.
A patient is considered healthy if he can stand on the injured leg, walk and move without pain or any restrictions.
What are the restoration procedures aimed at?
The specialist has many tasks:
- To restore the muscles, ligaments and tendons to their previous elasticity and normalize their tone.
- Restore motor functions of the leg, avoid muscle atrophy.
- To activate blood supply and lymph flow in the area of not only the heel, but also the entire leg.
- Reduce tissue edema, avoid inflammation and other complications after fracture.
- Speed up the healing process.
- Relieve pain.
These tasks can be accomplished using a comprehensive therapy tailored to the individual patient. Doctors of “Blagopoluchiya” pay attention not only to the procedures themselves. They help patients position their feet correctly to avoid additional stress on the heel.
Contraindications for fracture
Some patients believe that rehabilitation procedures are necessary mainly while wearing a cast.But rehabilitation after a heel fracture after removing the cast is equally important. During this period, you should also follow the doctor’s recommendations, do not overload the joint, wear special orthopedic shoes, selected by a specialist. Self-medication or neglect of therapy can lead to repeated injury, pain, displacement of the bone, etc.
Doing exercise therapy after a fracture is possible only with the permission of a doctor: even seemingly small loads can lead to serious consequences. The doctor selects the type of exercises, monitors the technique of execution, the patient’s condition, determines the number of repetitions and the amplitude of movements.
When drawing up a rehabilitation program, the doctor carefully examines the patient in order to clarify the absence of contraindications to any of the recommended treatment methods. As a rule, a number of techniques are contraindicated for oncological, psychological, infectious, skin diseases, chronic diseases in the acute stage, etc.
Fracture of the calcaneus: rehabilitation in the center “Wellbeing”
We are attentive to each patient: all conditions for a comfortable stay of sedentary patients.All our premises have a non-slip, non-threshold coating, wide doorways, ramps and handrails, we provide crutches, wheelchairs, we select orthoses and insoles.
The “Well-being” center uses only modern equipment, and the doctors of the center regularly improve their qualifications in order to restore health and well-being to patients as soon as possible.
Damage to growth zones – treatment, symptoms, causes, diagnosis
The growth zone, also called the epiphyseal plate or physis, is the area of growing tissue at the end of the long bones in children and adolescents.Each long bone has at least two growth plates, one at each end. The growth of the plate determines the future length and shape of mature bone tissue. After the completion of growth at the end of puberty, the growth of the plates is completed and this zone is replaced by hard bone tissue.
Damage to the plates occurs in children and adolescents. The plates are the weakest area of the growing skeleton, even weaker than the adjacent ligaments and tendons that connect bones to other bones and muscles.A child growing up with severe joint injuries is more likely to damage the growth plates than the ligaments responsible for joint stability. Injuries that can cause sprains in adults can damage the growth plates in children.
Damage to growth plates occurs in fractures. They account for 15 percent of all childhood fractures. They are twice as common in boys as in girls, and are most common in 14-16 year old boys and 11-13 year old girls.In girls in the older age group, fractures are less common, as the musculoskeletal system in girls matures earlier than in boys. As a result, in girls, the formation of bone tissue is completed earlier and the growth plates are replaced by dense bone tissue. About half of all growth plate injuries occur in the lower forearm (radius) or elbow. These injuries are also common in the lower leg (lower leg and fibula). They can also occur in the upper leg (thigh) or in the ankle and foot.
Although growth plate injuries are usually associated with acute trauma (falling or hitting a limb), damage can also be caused by chronic trauma resulting from excessive frequent stress. For example, such damage to the growth plates can occur in athletes: gymnasts, track and field athletes, baseball players.
Based on certain studies of injuries in children, data have been obtained that damage to growth plates occurs as a result of falls on the playground or from chairs.Sports such as football, athletics and gymnastics account for one third of all injuries. Other physical activities, such as cycling, sledding, skiing and skateboarding, account for one-fifth of all growth plate fractures. Injuries from driving a car, motorcycle, and related traffic accidents account for only a small percentage of growth plate fractures.
If a child has pain after an acute injury or excessive stress that does not disappear or changes in physical activity or there is local soreness, then a doctor’s consultation is imperative.A child, in no case, should move through pain. Children who play sports often experience some discomfort as they have to perform new movements. In some cases, the appearance of certain unpleasant sensations is quite predictable, but, nevertheless, any complaint of the child deserves attention as some injuries, in the absence of adequate treatment, can lead to irreversible changes and disrupt the proper growth of the bones of the injured limb.
Although most growth plate injuries are associated with injuries during play or sports, there are other causes of damage to growth zones (eg, bone infection) that can alter normal bone growth and development.
Other possible causes of injury to growth plates
Child abuse can cause bone injury, especially in young children who are just beginning to grow bone.
Exposure to cold (eg, frostbite) can also damage growth plates in children and can result in short fingers in older age or early development of degenerative arthritis.
Radiation radiation, which is used to treat certain types of cancer in children, can damage the growth of the plate.Moreover, recent studies have shown that chemotherapy used to treat cancer in children can negatively affect bone growth. Long-term use of steroids for the treatment of rheumatoid arthritis has a similar effect.
The presence of certain neurological disorders in children that lead to sensory deficits or muscle imbalances increases the risk of growth plate fractures, especially in the ankle and knee areas.
These types of injuries are often seen in children who are born insensitive to pain.
The area of growth zones is the site of application of many hereditary diseases that affect the musculoskeletal system. Science is gradually studying genes and gene mutations involved in the formation of the skeleton, the growth and development of bone tissue. Over time, these studies will help treat various abnormalities in the normal functioning of the growth plates.
- Inability to continue playing due to pain after an acute injury.
- Decreased ability to play for a long time due to persistent pain following an injury.
- Visually noticeable deformity of the child’s arm or leg.
- Severe pain and inability to move after injury.
After clarifying the circumstances of the injury, the doctor will order an X-ray to determine the type of fracture and develop a treatment plan. Since the growth zones do not have the same density as the bones, X-ray does not visualize them and they are defined as gaps (gaps) between the metaphysis and the pineal gland of the long tubular bone.Due to poor visualization of growth zones on radiography, it is recommended to perform radiography of the paired limb for image comparison.
MRI (magnetic resonance imaging) allows you to clearly visualize changes in tissues and, therefore, can be prescribed to diagnose damage to growth plates. In some cases, it is possible to use other diagnostic methods, such as computed tomography (CT) or ultrasound examination.
Classification of growth plate fractures (Salter and Harris)
Fractures of growth plates are divided into 5 types:
- Type I
The epiphysis is completely separated from the end of the bone or metaphysis, through the deep layer of the growth plate.The growth plate remains attached to the pineal gland. The doctor needs to perform a reposition if there is a displacement. With this type of fracture, immobilization with plaster of paris is required for full consolidation. As a rule, the likelihood of full recovery of the bone with this type of fracture is very high.
- Type II
This is the most common type of growth plate fracture. The pineal gland, together with the growth plate, is separated from the metaphysis. As with type I fractures, type II fractures usually require reduction and rigid plaster fixation.
- Type III
This type of fracture occurs in rare cases, usually in the lower leg, in the tibia. This occurs when the fracture passes completely through the pineal gland and separates part of the pineal gland and the growth plate from the metaphysis. Such fractures often require surgical restoration of the articular surface. The prognosis for such fractures is good if there is no violation of the blood supply to the separated part of the pineal gland and there are no pronounced displacements of the fragments.
- Type IV
This fracture passes through the pineal gland, through the entire growth plate and into the metaphysis.This type of fracture requires surgical reconstruction of the bone geometry and alignment of the growth plate. If the reconstruction is not carried out efficiently, then the prognosis for this type of fracture may not be very good. This injury occurs most often at the end of the humerus next to the elbow.
- Type V
This is a rare type of injury when the end of the bone is fractured and the growth plate is compressed. Most often, this type of fracture occurs in the knee or ankle. The prognosis is poor, since premature ossification of the growth zone is almost inevitable.
A new classification, called the Peterson classification, also distinguishes between type VI fractures, in which part of the pineal gland, growth plate, and metaphysis are missing. This usually occurs with open wounds or fractures (injuries from agricultural machinery, snowmobiles, lawn mowers, or gunshot wounds). With type VI fracture, surgical intervention is required, and in most cases, late reconstructive or corrective operations are necessary. Bone growth is almost always impaired.
As a rule, a trauma doctor deals with the treatment of injuries (with the exception of minor ones). In some cases, a pediatric orthopedic traumatologist is required, since traumas in children often have their own characteristics.
Treatment for fractures depends on the type of fracture. Treatment, which should be started as early as possible after injury, is usually as follows:
- Immobilization. A plaster cast or splint is applied to the injured limb and restricts any activity of the child that may put pressure on the injured area.
- Reposition. In the presence of displacement of fragments, manual reduction or often surgical reduction with fixation of fragments is necessary. Fixation is necessary for normal consolidation of bone tissue. After reduction, a plaster cast is applied, capturing the growth zone and the joint. Immobilization in a cast is necessary for several weeks to several months until normal consolidation of bone tissue occurs. The need for operative restoration of the integrity of bone structures is determined by the size of the displacement, the presence of a risk of damage to nearby vessels and nerves, and the age of the child.
- Exercise therapy is prescribed only after the completion of bone tissue regeneration. Long-term follow-up by a physician is necessary to assess adequate bone growth as the growth zones are injured. Therefore, it is recommended to carry out radiography of the extremities at intervals of 3-6 months, within 2 years after the fracture of the growth zones. Some fractures require follow-up until the child’s growth is complete.
In almost 85 percent of growth plate fractures, complete healing occurs without any consequences.
Disorders of bone tissue formation in the growth plate injury occur in the following cases:
- Severity of injury. If the injury causes impaired blood flow to the pineal gland, then the growth of bone tissue is impaired. Also, when the growth plate is displaced, destroyed or compressed, the growth of bone tissue may slow down. The presence of an open injury can entail the risk of infection and infection can destroy the growth plate.
- Child’s age. At a young age, damage to the growth plates can lead to more serious disruptions in the development of bone tissue, as a large increase in bone growth is required.And therefore, in case of fractures in early childhood, long-term medical supervision is required. At the same time, the younger bone tissue has a greater regenerative capacity.
- Localization of growth zones fractures. For example, growth zones in the knee are more responsible for extensive bone growth than others.
- Type of growth plate fracture – Type IV and V are the most severe.
Treatment depends on the above factors and is also based on prognosis.
The most common complication of growth plate fractures is premature arrest of bone growth. The affected bone grows more slowly than it would without injury, and as a result, the limb may be shorter than the intact limb. If only part of the growth plate is damaged, bone growth can be in one direction and limb curvature occurs. Growth injuries in the knee are at greatest risk of complications. Since trauma to the growth zone in the knee is often accompanied by damage to the nerves and blood vessels, therefore, injuries to the growth zones in the knee are often accompanied by impaired bone growth and curvature of the limb.
Currently, leading research clinics are conducting studies exploring the possibilities of stimulating tissue regeneration using the results of genetic engineering, which will allow in the future to avoid stunted growth and deformity of limbs after injuries to growth zones.
90,000 Polyurethane splints in traumatology: a modern alternative to plaster
The classic way to treat fractures is to apply a plaster cast. It helps to fix the damaged bone and provide it with peace, in other words, create optimal conditions for correct and fastest fusion.Plaster cast is a time-tested, reliable and effective way to treat fractures. But it has some disadvantages that cause inconvenience to both patients and doctors:
- Plaster cast is very uncomfortable to wash. Each visit to the shower turns into a real quest. It is necessary to carefully wrap the splint with cellophane and constantly make sure that no water gets under it.
- Gypsum is a rather heavy material. If it had to be applied to the hand or forearm, it is not so bad.It is much more difficult for patients with leg fractures.
- Gypsum tends to crumble. Because of this, it irritates the skin and causes itching. And scratching under the bandage will not work.
- Rigid immobilization not only helps, but also harms. In the human body there is a rule: “what does not work – atrophies.” If you wear a splint for a long time, inactive muscles weaken, mobility in the joint is impaired. Bone tissue weakens without stress – osteoporosis develops in it.
- If the plaster cast constantly exerts strong pressure on the skin, blood circulation is impaired.Because of this, bedsores can appear, and nerve function is impaired. Circular “deaf” bandages are especially bad in this respect. After the fracture, edema develops, the tissues are squeezed inside the plaster case.
- Plaster does not transmit X-rays very well, so it is often difficult to control how well a fracture heals.
For a long time, all these shortcomings had to be put up with. There is nothing to be done: the fracture needs to be treated, and there were no alternatives to the good old plaster splints.Currently, alternatives have appeared and are already widely used in traumatology. Modern doctors are increasingly using polymer, or, as it is also called, plastic gypsum. This technology is also used by traumatologists at the SOVA clinic.
What is a polymer bandage made of and how does it work?
Actually, there is no gypsum as such in “plastic plaster”. It is a “gauze” made of polymer or fiberglass impregnated with polyurethane resin. Blanks are produced in the form of bandages or sheets.
When a patient with a fracture or dislocation is admitted to the trauma department, the doctor, if necessary, performs a reposition (restores the natural position of fragments or dislocated ends of the bones), and then applies a polyurethane bandage. As a rule, in order for it to activate and subsequently acquire its final hardness, it must be soaked in water. Some materials are activated when heated to 60–100 ° C.
Many types of such bandages can be remodeled and turned into removable orthoses.
What are the advantages of polyurethane splints?
Polymer materials are free from many of the drawbacks due to which traumatologists and their patients do not like plaster so much:
- They are not afraid of water. You can wash without removing the splint and without protecting it from getting wet. Some materials dry themselves after water procedures, others need to be dried with a hairdryer for some time.
- Polymer does not crumble or irritate the skin.
- Good X-ray permeability greatly simplifies the monitoring of the healing process.
- The polyurethane splint has a cellular structure and allows the skin to breathe.
- The workpieces stretch well in different directions, which makes it possible to perfectly shape the dressing in accordance with the contours of the body.
- Unlike plaster, many polyurethane dressings are not rigid, they are resiliently elastic. This helps to avoid problems with impaired blood circulation and muscle weakening.
- Polymer is on average 4–5 times lighter than gypsum.
Is everything that good?
No.Polyurethane splints have their drawbacks, and they can not always be used. Doctors in our clinic are sure to tell patients about this.
First of all, you need to understand that such material is more expensive than classic gypsum.