What are the common causes of pinky toe pain. How can you identify a broken, fractured, or sprained pinky toe. What are the most effective treatments for pinky toe injuries. When should you seek medical attention for a pinky toe injury. How long does it take for a pinky toe injury to heal.

Understanding Pinky Toe Injuries: Breaks, Fractures, and Sprains

The pinky toe, despite its small size, plays a crucial role in maintaining balance and supporting body weight during movement. When injured, it can cause significant discomfort and impair mobility. Let’s explore the various types of pinky toe injuries and their characteristics.

Broken Pinky Toe

A broken pinky toe, also known as a fracture, typically occurs due to direct trauma or excessive force applied to the toe. Common causes include stubbing the toe forcefully or dropping a heavy object on the foot.

Symptoms of a broken pinky toe include:

• A popping sound at the moment of injury
• Immediate, throbbing pain that may subside after a few hours
• Difficulty bearing weight on the affected foot
• Misalignment of the toe
• Swelling and bruising
• Possible damage to the toenail

Stress Fractures

Stress fractures, also called hairline fractures, are small cracks or bruises that develop within the bone over time. These injuries are often the result of repetitive activities, particularly high-impact sports involving running and jumping.

Key symptoms of a stress fracture in the pinky toe area include:

• Gradual onset of pain that worsens with activity
• Pain that eases with rest
• Swelling and tenderness
• Possible bruising

Dislocated Pinky Toe

A dislocated pinky toe occurs when the toe bones separate from their normal position. This can happen due to a forceful impact or overextension of the toe. Dislocations are common among athletes and individuals over 65 years old.

Symptoms of a dislocated pinky toe include:

• Pain upon moving the toe
• Visible misalignment or crooked appearance
• Swelling and bruising
• Numbness or tingling sensation

Diagnosing Pinky Toe Injuries: When to Seek Medical Attention

While minor toe injuries can often be treated at home, certain symptoms warrant immediate medical attention. Is it possible to distinguish between different types of pinky toe injuries without professional help? In most cases, a proper diagnosis requires medical expertise and imaging tests.

Consider seeking medical attention if you experience:

• Severe pain that doesn’t improve with home remedies
• Visible deformity or misalignment of the toe
• Inability to bear weight on the affected foot
• Signs of infection, such as increased redness, warmth, or pus
• An open wound or tear in the skin (open fracture)

A healthcare professional will likely perform a physical examination and may order X-rays to determine the exact nature and severity of the injury. This approach ensures appropriate treatment and prevents potential complications.

Treatment Options for Pinky Toe Injuries

The treatment for pinky toe injuries varies depending on the type and severity of the injury. Can most pinky toe injuries be treated at home? While some minor injuries may respond well to home care, it’s essential to follow proper guidelines and seek professional advice when necessary.

Home Treatment for Minor Injuries

For minor pinky toe injuries, the RICE method is often recommended:

1. Rest: Avoid putting weight on the injured foot
2. Ice: Apply cold packs for 20 minutes at a time, several times a day
3. Compression: Wrap the toe gently with a bandage
4. Elevation: Keep the foot elevated above heart level when resting

Over-the-counter pain relievers such as ibuprofen or aspirin can help manage pain and reduce inflammation.

Medical Treatment for Severe Injuries

For more severe injuries, medical intervention may be necessary:

• Broken toes: Treatment may involve wearing a walking boot or cast to immobilize the toe while it heals. In some cases, the doctor may splint the injured toe to the adjacent toe for support.
• Severe fractures: In rare cases, surgery may be required to realign the bone properly.
• Stress fractures: Treatment often involves rest, protective footwear, and gradually returning to normal activities under medical supervision.
• Dislocations: A healthcare professional may need to manually realign the toe, followed by immobilization to allow proper healing.

Recovery and Rehabilitation for Pinky Toe Injuries

The recovery process for pinky toe injuries varies depending on the type and severity of the injury. How long does it typically take for a pinky toe injury to heal completely? While minor injuries may heal within a few weeks, more severe injuries can take several months to fully recover.

Key aspects of the recovery process include:

• Following the prescribed treatment plan
• Gradually increasing weight-bearing activities as advised by a healthcare professional
• Performing recommended exercises to improve strength and flexibility
• Wearing appropriate footwear to protect the healing toe
• Attending follow-up appointments to monitor progress

It’s crucial to be patient during the recovery process and avoid returning to high-impact activities too soon, as this can lead to re-injury or prolonged healing time.

Preventing Future Pinky Toe Injuries

While accidents can happen, there are several steps you can take to reduce the risk of pinky toe injuries. How can you protect your pinky toe from future harm? Implementing these preventive measures can significantly decrease the likelihood of injury:

• Wear properly fitting shoes with adequate toe room
• Use protective gear when participating in high-risk activities or sports
• Be mindful of your surroundings to avoid tripping or stubbing your toe
• Strengthen your feet and ankles through targeted exercises
• Gradually increase the intensity of physical activities to prevent overuse injuries
• Address any underlying foot conditions that may increase your risk of injury

By taking these precautions, you can help maintain the health and function of your pinky toe, ensuring it continues to support your overall foot mechanics and mobility.

Understanding the Anatomy of the Pinky Toe

To fully appreciate the impact of pinky toe injuries, it’s helpful to understand the anatomy of this small but important digit. What makes the pinky toe unique in terms of its structure and function? Let’s explore the key anatomical features of the pinky toe:

Bone Structure

The pinky toe, also known as the fifth toe, consists of three small bones called phalanges:

• Proximal phalanx: The bone closest to the foot
• Middle phalanx: The central bone of the toe
• Distal phalanx: The bone at the tip of the toe

These bones are connected to the fifth metatarsal bone, which extends from the midfoot to the base of the pinky toe.

Joints and Ligaments

The pinky toe contains two joints:

• Proximal interphalangeal joint (PIP): Between the proximal and middle phalanges
• Distal interphalangeal joint (DIP): Between the middle and distal phalanges

Ligaments connect these bones and provide stability to the toe. The complex network of ligaments allows for flexibility while maintaining the toe’s structural integrity.

Muscles and Tendons

Several small muscles and tendons control the movement of the pinky toe:

• Flexor digiti minimi brevis: Helps to flex or bend the toe
• Abductor digiti minimi: Assists in moving the toe away from the other toes
• Interossei muscles: Aid in spreading and bringing the toes together

Understanding this anatomy helps explain why pinky toe injuries can be so painful and impact overall foot function. The intricate structure of bones, joints, ligaments, and muscles all work together to provide balance and support during walking and other activities.

The Role of Footwear in Pinky Toe Health

Proper footwear plays a crucial role in maintaining pinky toe health and preventing injuries. How does your choice of shoes impact the well-being of your pinky toe? Let’s explore the relationship between footwear and pinky toe health:

The Importance of Proper Fit

Ill-fitting shoes are a common cause of pinky toe discomfort and injuries. Shoes that are too tight can lead to:

• Compression of the pinky toe, causing pain and potential deformities
• Increased risk of blisters, corns, and calluses
• Reduced blood circulation to the toe
• Higher likelihood of stubbing or injuring the toe due to restricted movement

Choosing the Right Shoes

When selecting shoes to promote pinky toe health, consider the following factors:

• Toe box width: Ensure there’s enough space for your toes to move freely
• Material flexibility: Opt for shoes with flexible uppers that can accommodate toe movement
• Arch support: Proper arch support helps distribute weight evenly across the foot
• Heel height: Excessively high heels can put undue pressure on the toes
• Activity-specific design: Choose shoes appropriate for your intended activities

The Impact of High Heels

High-heeled shoes can be particularly problematic for pinky toe health. These shoes often have narrow toe boxes and shift body weight onto the toes, increasing the risk of:

• Pinky toe compression and misalignment
• Development of bunionettes (tailor’s bunions) on the outside of the foot
• Increased pressure on the metatarsal bones, potentially leading to stress fractures

While occasional wear of high heels may not cause significant issues, frequent use can contribute to long-term pinky toe problems.

Protective Footwear

In certain situations, specialized protective footwear may be necessary to safeguard the pinky toe:

• Steel-toed boots for work environments with heavy objects
• Athletic shoes with reinforced toe areas for sports
• Hiking boots with sturdy toe protection for outdoor activities

By choosing appropriate footwear and being mindful of how your shoes affect your pinky toe, you can significantly reduce the risk of injuries and maintain overall foot health.

Long-Term Effects of Untreated Pinky Toe Injuries

While it may be tempting to ignore a minor pinky toe injury, failing to address the issue properly can lead to long-term consequences. What are the potential complications of leaving a pinky toe injury untreated? Let’s examine the possible outcomes:

Chronic Pain and Discomfort

Untreated injuries can result in persistent pain that may worsen over time. This chronic discomfort can lead to:

• Altered gait patterns to avoid pain, potentially causing issues in other parts of the body
• Reduced participation in physical activities and exercise
• Decreased overall quality of life due to constant pain

Deformities and Structural Changes

When injuries heal improperly, they can cause lasting changes to the toe’s structure:

• Malunion: Bones that heal in an incorrect position, leading to a permanently misshapen toe
• Hammertoe or claw toe deformities, where the toe becomes permanently bent
• Development of bone spurs or other bony growths

Arthritis and Joint Problems

Untreated injuries, particularly those involving joints, can increase the risk of developing arthritis:

• Post-traumatic arthritis, which can occur years after an initial injury
• Reduced range of motion in the affected toe
• Increased susceptibility to future injuries due to joint instability

Nerve Damage

In some cases, untreated injuries can lead to nerve complications:

• Persistent numbness or tingling in the toe
• Hypersensitivity to touch or pressure
• Reduced sensation, potentially increasing the risk of unnoticed injuries

Impact on Balance and Mobility

The pinky toe plays a role in maintaining balance and proper foot mechanics. Long-term injuries can affect:

• Overall stability, particularly during activities requiring quick movements
• Ability to perform certain exercises or sports effectively
• Risk of falls, especially in older adults

Given these potential long-term effects, it’s crucial to address pinky toe injuries promptly and appropriately. Seeking professional medical advice for persistent or severe symptoms can help prevent these complications and ensure proper healing.

Pinky Toe Broken, Fractured, or Sprained? Symptoms and Treatment

Your pinky toe may be small — but if it gets injured it can hurt big time.

Pain in the fifth toe is actually very common and can have many causes, including a break or sprain, tight-fitting shoes, a corn, bone spur, or some other factor.

Here’s a look at the possible causes of a painful pinky toe and what you can do.

Your pinky toe is prone to injury because of its location on the outside of your foot. The metatarsal bones leading to the fifth toe are one of the most common locations for foot injuries, especially for athletes.

If your toe is swollen and painful, and home remedies don’t help, it’s a good idea to see your doctor.

Proper treatment early on can help ensure that your toe heals correctly and it doesn’t lead to any other issues.

Let’s take a closer look at some of the most common causes for a painful small toe.

If you stub your toe really hard, or if you have a direct blow to your foot from a heavy object, your toe could be broken. A break is also called a fracture.

If you experience an open fracture, which includes an open wound or tear in the skin, you should see a doctor immediately.

Symptoms

The most common symptoms of a broken pinky toe include:

• a popping sound when the injury occurs
• throbbing pain that’s immediate and may fade after a few hours
• difficulty putting weight on your foot
• pinky toe seeming out of alignment
• swelling and bruising
• burning
• a damaged toenail

Treatment

Your doctor will likely X-ray your toe to examine the type of break. They’ll look for displacement, bone fragments, stress fractures, and injury to the metatarsal bones that connect to your pinky toe.

Treatment depends on the kind of break you have:

• If the toe bones are in alignment, your doctor may have you wear a walking boot or cast to immobilize the toe bones while they heal.
• For a simple break, your doctor may splint your pinky to your fourth toe to keep it in place while it heals.
• If the break is serious, surgery may be necessary to reset the bone.
• Your doctor will likely recommend over-the-counter (OTC) pain medications, rest, and home care.

A stress fracture, also known as a hairline fracture, is a small crack or bruise that develops within the bone over time. This typically happens from repetitive activities like high-impact sports that involve running and jumping.

Symptoms

Pain is the most common symptom of a stress fracture, and it can gradually get worse over time, especially if you continue putting weight on it. The pain is typically worse during activity and eases if you rest your foot.

Other common symptoms include:

• swelling
• bruising
• tenderness

Treatment

If you think you may have a stress fracture, you can perform the RICE method until you’re able to see a doctor. This involves:

• Rest: Try to avoid putting weight on your foot or toe.
• Ice: Use a cold pack (ice or ice pack wrapped in a moist cloth or towel) on your toe for 20 minutes at a time, several times a day.
• Compression: Wrap a bandage around your toe.
• Elevation: Rest with your foot raised up higher than your chest.

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin can help ease the pain and swelling.

Depending on the severity, stress fractures are often treated similarly to breaks.

Other fractures

Two other types of metatarsal fractures may also cause pain on the outside of your foot, including your pinky toe. This includes:

• Avulsion fracture. This happens when a tendon or ligament that’s attached to the metatarsal bone is injured and pulls a small piece of bone away with it. This tends to happen in sports, especially with sudden turns.
• Jones fracture. This is a break at the base of the fifth metatarsal bone.

With both types of fractures, the most common symptoms include:

• pain in the area of the fracture
• bruising and swelling of the foot
• pain when you try to put weight on your injured foot

When you bang your toe or stretch it too far backward, you can separate one pinky toe bone from another. This is called a dislocated toe.

Dislocation is fairly common among athletes and people over 65.

Your pinky and all the other toes, with the exception of your big toe, have 3 bones. Dislocation can occur at any of these joints.

The dislocation can be partial, which means the bones aren’t completely separated. This is known as subluxation. A full dislocation is when the bone is intact but completely out of its normal position.

It’s possible to dislocate one toe bone and also have an injury to another toe bone, such as a fracture.

Symptoms

The most common symptoms of a dislocated pinky toe include:

• pain when you move the toe
• a crooked appearance
• swelling
• bruising
• numbness or a pins-and-needles feeling

Treatment

Your doctor will examine your toe to feel for a dislocation. They may take an X-ray to confirm a diagnosis.

Sometimes other tests may be necessary to check if you have damage to your blood vessels or nerves.

In most cases, a doctor can manually put the dislocated bone back into position. This realignment is called a closed reduction. You may have a local anesthetic for this procedure so you don’t feel any pain.

Depending on how serious the dislocation is, you may need to wear an elastic bandage, splint, cast, or walking boot to keep the toe in alignment while it heals.

In some cases you may need surgery to fit the dislocated bone back into position. This is known as open reduction.

A sprained toe involves injury to a ligament, not your toe’s bone.

Ligaments are the connective tissue fibers that attach bones to each other and to joints. They’re different from tendons, which are the connective tissues that attach muscle to bones.

You can sprain your toe by bumping it hard or stretching it beyond its normal range of motion.

A sprained toe can be painful, but you’ll usually be able to walk on it.

Symptoms

The most common symptoms of a sprained pinky toe include:

• pain while moving the toe
• a throbbing sensation
• tenderness to the touch
• swelling
• bruising
• joint instability

Treatment

Treatment for a sprained pinky toe depends on the severity of the sprain. Sprains are categorized in 3 grades:

• Grade I: minimal pain and loss of function
• Grade II: moderate pain and difficulty putting weight on the toe
• Grade III: severe pain and an inability to put weight on the toe

For grade I sprains, you may only need to rest and ice your toe and possibly do buddy taping.

For grades II or III, your doctor may recommend additional measures, such as a walking boot.

A tailor’s bunion, also called a bunionette, is a bony bump on the outside of the base of your pinky. It can cause your pinky toe to become very painful.

Tailor’s bunions can be caused by an inherited abnormal structure of your foot, where the metatarsal bone moves outward while the pinky toe moves inward.

It can also be caused by shoes that are too narrow in the toe.

In both cases, the resulting bump gets irritated by shoes that rub against it.

Symptoms

The most common symptoms include:

• a bump on the toe that starts small but grows over time
• pain at the bunion site
• redness
• swelling

Treatment

Depending on the severity of your pain, your doctor may recommend:

• wearing shoes that have a wide toe box and avoiding shoes with high heels and pointy toes
• putting soft padding over the painful area
• orthotics to relieve pressure on the area
• a corticosteroid injection to reduce inflammation

In some cases, if pain interferes with your daily activities, or the bunion is more severe, your doctor may recommend surgery.

A corn consists of hardened layers of skin. It typically develops from your skin’s response to friction and pressure, like a shoe that’s too tight.

A hard corn on the outside of your pinky toe can be painful, especially if your shoe rubs against it. If the corn is deep set, it may lead to entrapment of a nerve or bursa (fluid-filled sacs around your joints).

Symptoms

The most common symptoms of a corn include:

• a tough, rough, yellowing patch of skin
• skin that’s sensitive to the touch
• pain when wearing shoes

Treatment

Your doctor may:

• shave a corn or advise you to file it after bathing
• recommend soft padding to relieve pressure on the corn
• recommend wearing wider shoes or stretching the toe box of your shoes

Several types of toe abnormalities can make your pinky toe painful, uncomfortable, or swollen.

Misshapen toes

When your posture or movement is unbalanced, it can put extra pressure on your feet that causes changes to your toes. You may develop a hammer toe or claw toe.

• A hammer toe is when your toe bends downward instead of straight ahead. It can be caused by an injury to the toe, arthritis, ill-fitting shoes, or a very high arch. Some people may be born with this condition.
• A claw toe is when your toe bends into a claw-like position. You may be born with a claw toe, or it may develop as a result of diabetes or another disease. If not treated, your toes can freeze into a claw position.

Both hammer toe and claw toe can become painful. They can also lead to the formation of corns, calluses, or blisters on the toe.

Other toes may also develop corns or calluses because of the abnormal pressure on them.

Treatment

• For both hammer toe and claw toe, your doctor may recommend a splint or taping to keep your toes in the proper position.
• For a claw toe, your doctor may recommend exercises to keep your toe flexible.
• For ongoing problems that don’t improve with conservative treatment, your doctor may recommend surgery to correct the toe.

Overlapping pinky toe

Some people are born with a pinky toe that overlaps the fourth toe. It’s thought to be inherited. In some cases, it can cause pain and discomfort. In about 20 to 30 percent of people, it occurs on both feet.

Sometimes children born with this condition self-correct as they begin walking.

It’s estimated that 50 percent of people with an overlapping fifth toe have pain, including bursitis, calluses, or problems with footwear.

Treatment

The first line of treatment is to use conservative therapies to try to reposition the pinky toe. This can include taping, splinting, and corrective shoes.

If these therapies aren’t effective and pain persists, surgery may be performed.

Your toes play an important role in keeping you balanced as you move, whether you’re barefoot or wearing shoes. Your pinky is the smallest toe, but it’s crucial in helping you to maintain your balance.

It helps to think of your foot as having a triangular base of balance. The triangle is formed by 3 points: your big toe, your pinky toe, and your heel. Damage to any part of that triangle can throw off your balance.

So, it makes sense that if your pinky toe gets hurts, it may throw off your balance and affect how you walk and move.

Be sure to get medical attention if you have intense pain or swelling in your pinky toe, are unable to put any pressure on it, or its out of alignment.

Structural abnormalities can also be remedied with medical treatment.

Less severe conditions, such as a mild sprain, can usually resolve with good home care and OTC products. Sometimes wearing good-fitting shoes with a wide toe box may correct what’s making your pinky toe painful.

Evaluation and Management of Toe Fractures

ROBERT L. HATCH, M.D. , M.P.H., AND SCOTT HACKING, M.D.

Am Fam Physician. 2003;68(12):2413-2418

Fractures of the toe are one of the most common lower extremity fractures diagnosed by family physicians. Toe fractures most frequently are caused by a crushing injury or axial force such as stubbing a toe. Joint hyperextension and stress fractures are less common. Most patients have point tenderness at the fracture site or pain with gentle axial loading of the digit. Anteroposterior and oblique radiographs generally are most useful for identifying fractures, determining displacement, and evaluating adjacent phalanges and digits. Referral is indicated in patients with circulatory compromise, open fractures, significant soft tissue injury, fracture-dislocations, displaced intra-articular fractures, or fractures of the first toe that are unstable or involve more than 25 percent of the joint surface. Most children with fractures of the physis should be referred, but children with selected nondisplaced Salter-Harris types I and II fractures may be treated by family physicians. Stable, nondisplaced toe fractures should be treated with buddy taping and a rigid-sole shoe to limit joint movement. Displaced fractures of the lesser toes should be treated with reduction and buddy taping. Patients with displaced fractures of the first toe often require referral for stabilization of the reduction.

Toe fractures are one of the most common fractures diagnosed by primary care physicians. In one rural family practice,¹ toe fractures comprised 8 percent of 295 fractures diagnosed; in an Air Force family practice residency program,² they made up 9 percent of 624 fractures treated. Published studies suggest that family physicians can manage most toe fractures with good results.^1,2

Anatomy

The first toe has only two phalanges; the second through the fifth toes generally have three, but the fifth toe sometimes can have only two (Figure 1). Flexor and extensor tendons insert at the proximal portions of the middle and distal phalanges. These tendons may avulse small fragments of bone from the phalanges; they also can be injured when a toe is fractured. Abductor, interosseus, and adductor muscles insert at the proximal aspects of each proximal phalanx. The pull of these muscles occasionally exacerbates fracture displacement. Sesamoid bones generally are present within flexor tendons in the first toe (Figure 1, top) and are found less commonly in the flexor tendons of other toes. In children, a physis (i.e., cartilaginous growth center) is present in the proximal part of each phalanx (Figure 2).

Differential Diagnosis

The same mechanisms that produce toe fractures may cause a ligament sprain, contusion, dislocation, tendon injury, or other soft tissue injury. Radiographs often are required to distinguish these injuries from toe fractures. Stress fractures can occur in toes. They typically involve the medial base of the proximal phalanx and usually occur in athletes. Stress fractures have a more insidious onset and may not be visible on radiographs for the first two to four weeks after the injury.

History and Physical Findings

Most toe fractures are caused by an axial force (e.g., a stubbed toe) or a crushing injury (e.g., from a falling object). Joint hyperextension, a less common mechanism, may cause spiral or avulsion fractures. Common presenting symptoms include bruising, swelling, and throbbing pain that worsens with a dependent position, although this type of pain also may occur with an isolated subungual hematoma. Although tendon injuries may accompany a toe fracture, they are uncommon.

Physical examination should include assessment of capillary refill; delayed capillary refill may indicate circulatory compromise. The skin should be inspected for open wounds or significant injury that may lead to skin necrosis. The nail should be inspected for subungual hematomas and other nail injuries. Deformity of the digit should be noted; most displaced fractures and dislocations present with visible deformity. Nondisplaced fractures usually are less apparent; however, most patients with toe fractures have point tenderness over the fracture site. The localized tenderness of a contusion may mimic the point tenderness of a fracture. Application of a gentle axial loading force distal to the injury (i.e., compressing the distal phalanx toward the foot) may distinguish contusions from fractures. If this maneuver produces sharp pain in a more proximal phalanx, it suggests a fracture in that phalanx.

Radiographic Findings

Radiographic studies of a toe should include anteroposterior, lateral, and oblique views (Figure 1). A combination of anteroposterior and lateral views may be best to rule out displacement. However, overlying shadows often make the lateral view difficult to interpret (Figure 1, center). In many cases, anteroposterior and oblique views are the most easily interpreted (Figure 1, top and bottom).

Fractures of the lesser toes are four times as common as fractures of the first toe. ³ Most toe fractures are nondisplaced or minimally displaced. Comminution is common, especially with fractures of the distal phalanx. Displaced spiral fractures generally display shortening or rotation, whereas displaced transverse fractures may display angulation. In children, toe fractures may involve the physis (Figure 2).

Fractures of multiple phalanges are common (Figure 3). Therefore, phalanges and digits adjacent to the fracture must be examined carefully; joint surfaces also must be examined for intra-articular fractures (Figure 3). Patients with intra-articular fractures are more likely to develop long-term complications.

Indications for Referral

Patients with circulatory compromise require emergency referral. Toe fractures of this type are rare unless there is an open injury or a high-force crushing or shearing injury. Patients with open toe fractures or fractures with overlying skin necrosis are at high risk for osteomyelitis. If there is a break in the skin near the fracture site, the wound should be examined carefully. If the wound communicates with the fracture site, the patient should be referred. In some practice sites, family physicians manage open toe fractures; a discussion about the management of this type of injury can be found elsewhere.^3,4 Patients also may require referral because of delayed complications such as osteomyelitis from open fractures, persistent pain after healing, and malunion.

FRACTURES OF THE FIRST TOE

Because of the first toe’s role in weight bearing, balance, and pedal motion, fractures of this toe require referral much more often than other toe fractures. Deformity, decreased range of motion, and degenerative joint disease in this toe can impair a patient’s functional ability.

Referral is recommended for patients with first-toe fracture-dislocations, displaced intra-articular fractures, and unstable displaced fractures (i.e., fractures that spontaneously displace when traction is released following reduction). Referral also is recommended for children with first-toe fractures involving the physis.⁴ These injuries may require internal fixation.

Referral should be strongly considered for patients with nondisplaced intra-articular fractures involving more than 25 percent of the joint surface (Figure 4).⁴ These fractures may lose their position during follow-up. Even if the fragments remain nondisplaced, significant degenerative joint disease may develop.⁴

Referral also should be considered for patients with other displaced first-toe fractures, unless the physician is comfortable with their management.

FRACTURES OF THE LESSER TOES

Although referral rarely is required for patients with fractures of the lesser toes, referral is recommended for patients with open fractures, fracture-dislocations (Figure 5), displaced intra-articular fractures, and fractures that are difficult to reduce. Referral is recommended for children with fractures involving the physis, except nondisplaced Salter-Harris type I and type II fractures (Figure 6). ⁴

Patients with unstable fractures and nondisplaced, intra-articular fractures of the lesser toes that involve more than 25 percent of the joint surface (Figure 3) usually do not require referral and can be managed using the methods described in this article.

Treatment

STABLE, NONDISPLACED FRACTURES

Patients with closed, stable, nondisplaced fractures can be treated with splinting and a rigid-sole shoe to prevent joint movement. To enhance comfort, some patients prefer to cut out the part of the shoe that overlies the fractured toe. A walking cast with a toe platform may be necessary in active children and in patients with potentially unstable fractures of the first toe.

The preferred splinting technique is to buddy tape the affected toe to an adjacent toe (Figure 7).⁴ Treatment should continue until point tenderness is resolved, usually at least three weeks (four weeks for fractures of the first toe). Taping may be necessary for up to six weeks if healing is slow or pain persists.

To control pain and swelling, patients should apply ice and elevate the affected foot for the first few days after the injury. Patients should limit icing to 20 minutes per hour so that soft tissues will not be injured. Non-narcotic analgesics usually provide adequate pain relief. Narcotic analgesics may be necessary in patients with first-toe fractures, multiple fractures, or fractures requiring reduction.

If an acute subungual hematoma is present (less than 24 hours old), decompression may relieve pain substantially. Despite theoretic risks of converting the injury to an open fracture, decompression is recommended by most experts.⁵ Toenails should not be removed because they act as an external splint in patients with fractures of the distal phalanx.

After the splint is discontinued, the patient should begin gentle range-of-motion (ROM) exercises with the goal of achieving the same ROM as the same toe on the opposite foot. Follow-up radiographs may be taken three to six weeks after the injury, but they generally do not influence treatment and probably are not necessary in nondisplaced toe fractures.

DISPLACED FRACTURES OF LESSER TOES

Most displaced fractures of the lesser toes can be managed by family physicians if there are no indications for referral. Although adverse outcomes can occur with toe fractures,³ disability from displaced phalanx fractures is rare.⁵

After anesthetizing the toe with ice or a digital block, the physician holds the tip of the toe, applies longitudinal traction, and manipulates the bone fragments into proper position. In most cases, this is done by simply adjusting the direction of traction to correct any shortening, rotation, or malalignment. To unlock fragments, it may be necessary to exaggerate the deformity slightly as traction is applied or to manipulate the fragments with one hand while the other maintains traction. Following reduction, the nail bed of the fractured toe should lie in the same plane as the nail bed of the corresponding toe on the opposite foot. If it does not, rotational deformity should be suspected. Unless it is fairly subtle, rotational deformity should be corrected by further manipulation.

The reduced fracture is splinted with buddy taping. Fracture position ideally will be maintained when traction is released, but in some cases the reduction can be held only with buddy taping. Referral is indicated if buddy taping cannot maintain adequate reduction.

DISPLACED FRACTURES OF THE FIRST TOE

Displaced fractures of the first toe generally are managed similarly to displaced fractures of the lesser toes. To minimize the possibility of future disability, the position of the bone fragments after reduction should be as close to anatomic as possible. If the reduction is unstable (i.e., the position is not maintained after traction is released), splinting should not be used to hold the reduction, and referral is indicated.

To check proper alignment, radiographs should be taken immediately after reduction and again seven to 10 days after the injury (three to five days in children). ⁴ In patients with potentially unstable or intra-articular fractures of the first toe, follow-up radiographs should be taken weekly for two or three weeks to monitor fracture position. At the conclusion of treatment, radiographs should be repeated to document healing.

Complications

A common complication of toe fractures is persistent pain and a decreased tolerance for activity. Pain that persists longer than a few months may indicate malunion, which may limit a patient’s future activities significantly. Toe fractures, especially intra-articular fractures, can result in degenerative joint disease, and osteomyelitis is a potential complication of open fractures.

Fracture of the little finger on the leg

Fracture of the phalanx of the little toe is a fairly common type of injury, because it is not at all difficult to “earn” it. Most often, a fracture of the little finger on the leg occurs when playing football, as a result of a heavy object falling on the leg, squeezing the fingers, twisting the leg. But, even just stumbling on a flat floor, you can break this finger, because. the bones are very thin.

In some cases, a fracture of the little finger on the leg may be associated with a weakening of the strength properties of bone tissue due to a number of diseases:

• osteoporosis;
• hyperparathioresis;
• osteomyelitis;
• tumor processes, etc.

However, whatever the cause of a broken toe, medical attention is required to avoid complications. It should be borne in mind that as a result of a fracture, damage to the motor nerve or adhesion of the tendons may occur, which as a result often leads to the loss of the functions of the little finger. Also, after a fracture, a purulent process may develop, threatening amputation of the finger.

Symptoms of a fracture of the little toe

The main signs of a fracture of the little toe are:

• sharp pain that occurs immediately after injury;
• increased pain when trying to move the little finger;
• swelling, redness of the skin on the finger;
• hemorrhage under the skin;
• abnormal mobility of the injured finger;
• violation of the integrity of the skin (in the case of an open fracture).

On palpation of the little finger, a crunch of bone fragments is felt, and the finger itself assumes an unnatural position. As time passes, the pain intensifies, swelling begins to seize the other fingers and foot. The severity of symptoms depends on the severity and location of the fracture. In the case when the main phalanx adjacent to the foot is damaged, the size of the edema and hematoma will be greater than when the distal phalanx is damaged.

Little toe fracture – what to do?

The first thing to do in case of a fracture is to call a doctor. If for some reason it is impossible to get medical help quickly, you should proceed as follows:

1. Limit the load on the leg and keep it in an elevated position.
2. In case of an open fracture, disinfect the wound.
3. Apply a cold compress to the injured finger to prevent swelling (for 10 to 15 minutes).
4. Bandage the little finger tightly to the adjacent finger.
5. For severe pain, take pain medication.

Fracture of the little finger on the leg – treatment

First of all, after a medical examination, an x-ray is required to determine the nature of the fracture. Depending on this, therapeutic measures will be carried out, but, first of all, anesthesia is performed for any fracture.

A fracture of the nail phalanx may require perforation of the nail plate (if blood has accumulated underneath). A plaster bandage for a fracture of such localization is not required. The little finger can be fixed with a plaster to the adjacent healthy finger for about two weeks.

If the middle or main phalanx is broken, a plantar plaster splint is applied for a period of 1 to 1.5 months. In the warm season, it is recommended to replace gypsum with scotchcast (a modern synthetic substitute for gypsum).

In the case of a compound fracture with a dislocation, an open reposition of the bones of the finger is required, which is performed under local anesthesia. If there is an open wound, a tetanus shot and antibiotics may be needed.

It is recommended to keep the foot immobile throughout the treatment, it is forbidden to step on it. It is best to place the injured leg in an elevated position on a cushion or bolster.

How to develop the little finger after a fracture?

After complete healing of the fracture, to restore the functions of the damaged little finger, a rehabilitation course is prescribed, including physical procedures, massage, physiotherapy exercises, vitamin therapy. The recovery period takes about two months.

Related articles:

Methods of Treatment of Fracture of the Little Toe, Possible Complications

In order to know which treatment of the fracture of the little toe will be most effective, it is necessary to diagnose and establish the specific type of damage.

Like most other injuries of bone tissue in the human body, a violation of the integrity of the bone in the phalanx of the little finger of the lower limb can occur for various reasons and differ in some characteristic features and signs that significantly affect the choice of treatment for this problem.

Photo: ways to quickly treat a broken little finger on the leg without complications and consequences

Causes and symptoms of injury

Modern medicine considers various mechanisms for obtaining such damage, which have a significant impact on the selection of the most adequate treatment and then rehabilitation methods.

Among the most common causes that can provoke a broken integrity of the bone structure of the little finger of the lower limb, it is worth paying special attention to:

• incorrect rotation of the foot;
• unexpected impacts or impacts of great intensity;
• altered bone strength due to the pathological condition of the bones: osteoporosis, tuberculosis, osteomyelitis and oncological diseases.

Among the injuries of all fingers of the lower limb, the little finger is the most susceptible to injury. This feature is associated with the anatomical localization of the last toe, which leads to frequent blows and bruises.

There is absolutely no difficulty in suspecting such a diagnosis, since both in the case of a closed and an open type of fracture, which occurs only in rare cases, the symptoms of the disease remain quite pronounced even for a non-specialist.

The video in this article introduces the fact that the most characteristic symptomatic signs are:

• severe soreness;
• increased pain intensity when trying to move and touch the injured little finger;
• visual swelling of the injured foot;
• the presence of extensive hemorrhage under the skin;
• the ability to hear crackling in case of palpation;
• increase in pain and its transition to the area of ​​neighboring fingers.

The main symptomatic manifestations of impaired integrity of the little finger of the lower limb

From a visual point of view, the instruction recommends paying attention to the presence of a defect, shortening and unusual mobility of the finger, as well as to its incorrect position. All of the above characteristics indicate a broken integrity of the little toe on the leg.

Terms of healing, treatment and complete healing of a broken phalanx of the little toe

Before treating a fracture of the little toe, it is necessary to provide the victim with first aid. Since injuries in a closed form occur in the predominant number of clinical cases in traumatology, it is not at all necessary for the patient to call an ambulance team to the scene, given his ability to get to a specialized medical facility on his own.

First aid to the patient consists of the following activities:

Action	Reason and effectiveness of this technique
Wound treatment	Can be done with any available medication to prevent or minimize the risk of viruses or infections entering the body of the affected person. Thus, the main action is to disinfect the formed wound at the site of the impact. Wound dressing methods for decontaminating a patient with injuries
Stop or prevent possible bleeding	The duration of heavy or even minimal bleeding can damage larger vessels or arteries in the body, as well as cause loss of consciousness in the patient. In this case, it is not recommended to lose blood due to an open wound, which can be eliminated with improvised means even before an ambulance arrives or sees a doctor. Bleeding as a cause of complications after a fracture
Splinting	In most cases, splinting is practiced in cases of displaced bone fragments. It should be noted that the fixative is not only a method of eliminating the initial symptoms of injury, but also an effective way to cure a fracture of the little toe on the leg. Thus, the injured finger is fixed in one, the most successful and safest position for human life, after which a decision is made regarding the treatment method based on the radiography performed. Application of a temporary and permanent fixation splint for the little finger
Use of antibacterial agents	Antibacterial drugs are the answer to the question of how to treat a chronic fracture of the little toe, since in this case the doctor has to deal not only with improperly healed bone, but also with chronic pain associated with the injury. Taking antibacterial agents also helps prevent the risks of secondary infections entering the body of a sick person. Antibacterial treatment of trauma diseases
Plastering	It is possible to resort to the use of a plaster cast on an injured finger of the lower limb in case of fractures with displaced bone fragments. Modern ways of fixing an injured little toe

It is necessary to pay attention to the fact that how to quickly cure a fracture of the little finger is also significantly influenced by the use of other methods for the correct and reliable fixation of the finger of the lower limb.

It is possible to replace the well-known plaster bandage with a synthetic bandage or adhesive tape in modern traumatology. The period of wearing it depends on the exact localization of the damage and the presence of concomitant serious injuries of the body: basically it is about two to three weeks.

Carrying out an x-ray to diagnose a fracture of the toe

Additional, auxiliary medications are:

• vitamin-based complexes;
• massage treatments;
• physical procedures;
• physiotherapy operations.

In some, rare cases, the doctor may recommend that a patient with the above damage undergo a special course of neurostimulation for a speedy and complete recovery.

A single visual examination by a traumatologist is not sufficient to make an accurate and specific diagnosis. For this, an x-ray examination is performed in two projections. Thus, the nature and degree of complexity of the fracture is confirmed, after which the specialist proceeds to the choice of how the fracture of the little finger on the leg is treated.

If there is accumulated blood under the nail or skin, it is necessary to proceed with perforation, after which a cast is not necessary. In this case, it is possible to fix the injured little finger with the help of a special patch, using the adjacent finger as a solid base.

Immobilization of a broken little finger with an adjacent healthy finger

An injury in the area of ​​the middle and main phalanges needs reliable immobilization with a plaster splint. The patient has to keep it on for two months.

Scotchcast is a substitute for summer. The presence of displaced bone fragments is the main reason for bone reposition under local anesthesia.

What are the possible complications of an untreated fracture of the little toe and the patient’s rehabilitation

It is not uncommon for various complications and serious consequences for the health and functionality of the leg to occur after a broken toe of the lower extremity. If a fracture of the little toe is not treated or medical care is provided untimely or incorrectly, the patient may remain limited in his movements for life, suffering from constant pain of a aching nature.

Most of the complications concern the injured bone itself, as it begins to lose its functionality due to the prolonged influence of the formed hematoma. If the elimination of accumulated blood under the skin or the nail plate is impossible or ineffective, the specialist has to resort to the complete removal of the nail.

Quite often, after treatment of the above damage to the little finger, patients begin to complain of the development of rheumatoid arthritis. The main signs in this case will be constrained movements, severe pain and deformation of the little finger.

During the treatment, the healing of the bone is regularly monitored by the doctor using x-rays. Inappropriate treatment conditions can lead to incomplete healing of the little finger phalanx bone or to improper fusion of bone and soft tissues. Determination of these phenomena is the reason for immediate surgical intervention.

Important! It is impossible to ignore such a serious complication as osteomyelitis, which is essentially a purulent lesion of bone tissue.