What’s the Best Thing to Do for a Broken Toe?

October 14, 2022
|
Family Medicine

Most people don’t give much thought to the bones in their toes — until they break one. Clinically known as toe fractures, broken toes are fairly common injuries, and the smaller toes are more frequently broken than the big toe.

Of the 26 bones in your foot, 14 are in your toes. The big toes each comprise two bones and one joint, while the four smaller toes each have three bones and two joints. The bone closest to the foot is called the proximal, while the bone closest to the end of the toe is the distal. The middle bone is between the two; the big toe has no middle bone.

There are many possible causes of broken toes, but the most common include stubbing or banging your toe on a hard surface (such as a concrete curb or a couch leg), dropping a heavy object on it, or rolling it while walking or running. Diseases that affect bone density, such as osteoporosis, raise the risk of broken bones.

In general, there are many causes of foot pain.

Anyone can break a toe, but toe fractures happen most often among athletes and active people. Big toe fractures and sprains often are caused by repetitive pushing off the toe while running or jumping; this is known as “turf toe.”

Other types of toe fractures include stress fractures caused by repetitive activity, such as running or kicking, and a small chip fracture on the bone called an avulsion fracture.

Broken toe symptoms can range from mild to severe and may include:

• Sudden intense pain
• Throbbing
• Significant bruising of the toe or toenail
• Swelling and/or tenderness
• Pain with weight bearing or walking
• Toe appears to be out of place

Especially with the smaller toes, the symptoms of a sprain and fracture can be very similar.

“It can be difficult to know if you’ve broken a toe or just severely sprained or bruised it,” says Jacob Braunstein, MD, an orthopedic surgeon specializing in foot and ankle surgery at Scripps Clinic Jefferson and Scripps Clinic Torrey Pines.

“It’s a common myth that if you can move your toe, it isn’t broken, but that is not always the case. You might be able to wiggle a broken toe or even walk on it, but movement can actually make it worse.”

If you suspect you’ve broken or sprained a toe, immediately apply an ice pack to it for 20 minutes to help decrease swelling and pain. Never apply ice directly to your skin; place a towel between the ice and skin to prevent frostbite. An over-the-counter pain medication, such as ibuprofen, can help relieve pain and swelling.

Then, make an appointment with your doctor to have it checked out.

“The majority of toe fractures can be managed by a primary care physician,” says Dr. Braunstein. “If your primary care physician has any further concerns, they can provide you with a referral to a specialist.”

Without appropriate medical treatment, broken toes may heal improperly and can cause chronic pain, arthritis of the toe joint, deformity of the toe or foot, movement restrictions and difficulty walking or wearing shoes.

“Many people believe there’s nothing a doctor can do for a broken toe, but that is not true,” says Tara Robbins, MD, a family medicine physician with expertise in sports medicine at Scripps Clinic Del Mar. “It’s important to have any possible fracture examined and treated as soon as possible to help reduce pain, prevent further damage and ensure proper healing.”

If the break is not severe, treatment for broken, sprained or bruised toes is often the same. In addition to recommending ice and rest, your doctor may show you how to splint an injured toe by taping it to the closest healthy toe for support. This is known as “buddy taping.”

A cast may be needed for toe bones that are dislocated or badly broken to immobilize them while they heal. Big toe fractures, which are more likely to involve joint or ligament damage, may require surgery.

Broken toes usually heal within four to six weeks.

Related tags:

• Health and Wellness
• Family Medicine

Toe and Forefoot Fractures – OrthoInfo

Fractures of the toes and forefoot are quite common. Fractures can result from a direct blow to the foot — such as accidentally kicking something hard or dropping a heavy object on your toes. They can also result from the overuse and repetitive stress that comes with participating in high-impact sports like running, football, and basketball.

Although fracturing a bone in your toe or forefoot can be quite painful, it rarely requires surgery. In most cases, a fracture will heal with rest and a change in activities.

The bones of the forefoot.

The forefoot has 5 metatarsal bones and 14 phalanges (toe bones). There are 3 phalanges in each toe — except for the first toe, which usually has only 2.

All the bones in the forefoot are designed to work together when you walk. A fracture, or break, in any of these bones can be painful and impact how your foot functions.

Toe and forefoot fractures often result from trauma or direct injury to the bone. Fractures can also develop after repetitive activity, rather than a single injury. This is called a “stress fracture.”

Fractures may either be:

• Non-displaced, where the bone is cracked but the ends of the bone are together
• Displaced, where the end of the broken bones have partially or completely separated

Fractures can also be divided into:

• Closed fractures, where the skin is not broken
• Open fractures, where the skin is broken, and the wound extends down to the bone. Open fractures are particularly serious because, once the skin is broken, bacteria can enter the wound and cause infection in the bone. Immediate treatment is required to prevent infection.

The most common symptoms of a fracture are pain and swelling. Other symptoms may include:

• Bruising or discoloration that extends to nearby parts of the foot
• Pain with walking and weight bearing

If you think you have a fracture, it is important to see your doctor as soon as possible. A fracture that is not treated can lead to chronic foot pain and arthritis and affect your ability to walk.

While you are waiting to see your doctor, you should do the following:

• Apply ice to help reduce swelling.
• Elevate your foot as much as possible.
• Limit weight bearing.
• Lightly wrap your foot in a soft compressive dressing.

To Top

Physical Examination

When you see your doctor, they will take a history to find out how your foot was injured and ask about your symptoms. Your doctor will then examine your foot and may compare it to the foot on the opposite side.

Your foot may become swollen and discolored after a fracture.

During the exam, the doctor will look for:

• Swelling
• Tenderness over the fracture site
• Bruising or discoloration — your foot may be red or ecchymotic (“black and blue”)
• Deformity
• Skin abrasions or open wounds
• Loss of sensation — an indication of nerve injury

Imaging Tests

Your doctor will also order imaging studies to help diagnose the fracture.

X-rays. X-rays provide images of dense structures, such as bone. An X-ray can usually be done in your doctor’s office.

Most fractures can be seen on a routine X-ray. A stress fracture, however, may start as a tiny crack in the bone and may not be visible on a first X-ray.

In many cases, a stress fracture cannot be seen until several weeks later when it has actually started to heal, and a type of healing bone called callus appears around the fracture site.

(Left) In this X-ray, a recent stress fracture in the third metatarsal is barely visible (arrow). (Right) Several weeks later, there is callus formation at the site and the fracture can be seen more clearly.

Magnetic Resonance Imaging (MRI) scans. If your doctor suspects a stress fracture but cannot see it on an X-ray, they may recommend an MRI scan. 

More sensitive than an X-ray, an MRI can detect changes in the bone that may indicate a fracture. Unlike an X-ray, there is no radiation with an MRI. 

To Top

Treatment for a toe or forefoot fracture depends on:

• The location of the injury
• The type of fracture

Fractures of the Toes

Even though toes are small, injuries to the toes can often be quite painful.

A fracture of the toe may result from a direct injury, such as dropping a heavy object on the front of your foot, or from accidentally kicking or running into a hard object. A fracture may also result if you accidentally hit the side of your foot on a piece of furniture on the ground — and your toes are twisted or pulled sideways or in an awkward direction.

The proximal phalanx is the toe bone that is closest to the metatarsals. Because it is the longest of the toe bones, it is the most likely to fracture.

A fractured toe may become swollen, tender, and discolored. If the bone is out of place, your toe will appear deformed.

Treatment

Most broken toes can be treated without surgery. For several days, it may be painful to bear weight on your injured toe. As your pain subsides, however, you can begin to bear weight as you are comfortable. During this time, it may be helpful to wear a wider than normal shoe.

Taping your broken toe to an adjacent toe can also sometimes help relieve pain.

If the bone is out of place and your toe appears deformed, it may be necessary for your doctor to manipulate, or reduce, the fracture. This procedure is most often done in the doctor’s office. You will be given a local anesthetic to numb your foot, and your doctor will then manipulate the fracture back into place to straighten your toe.

(Left) In this X-ray, a fracture in the proximal phalanx of the fifth toe (arrow) has caused the toe to become deformed. (Right) The bones in the angled toe have been manipulated (reduced) back into place.

Metatarsal Fractures

The metatarsals are the long bones between your toes and the middle of your foot. Each metatarsal has the following four parts:

• Head — which makes a joint with the base of the toe
• Neck — the narrow area between the head and the shaft
• Shaft — the long part of the bone
• Base — which makes a joint with the midfoot

Fractures can occur in any part of the metatarsal, but most often occur in the neck or shaft of the bone.

(Left) The four parts of each metatarsal. (Right) X-ray shows a fracture in the shaft of the 2nd metatarsal.

Like toe fractures, metatarsal fractures can result from either a direct blow to the forefoot or from a twisting injury.

Some metatarsal fractures are stress fractures. Stress fractures are small cracks in the surface of the bone that may extend and become larger over time.

Stress fractures are typically caused by repetitive activity or pressure on the forefoot. They are common in runners and athletes who participate in high-impact sports such as soccer, football, and basketball.

High-impact activities like running can lead to stress fractures in the metatarsals.

A stress fracture can also come from a sudden increase in physical activity or a change in your exercise routine.

Treatment

Most metatarsal fractures can be treated with an initial period of elevation and limited weight bearing. This is followed by gradual weight bearing, as tolerated, in a cast or walking boot. Surgery is not often required.

However, if you have fractured several metatarsals at the same time and your foot is deformed or unstable, you may need surgery.

During the procedure, your doctor will make an incision in your foot, then insert pins or plates and screws to hold the bones in place while they heal. This is called internal fixation.

Surgery may be delayed for several days to allow the swelling in your foot to go down. If you have an open fracture, however, your doctor will perform surgery more urgently.

Fifth Metatarsal Fractures

The fifth metatarsal is the long bone on the outside of your foot. Injuries to this bone may act differently than fractures of the other four metatarsals.

Most commonly, the fifth metatarsal fractures through the base of the bone. This usually occurs from an injury where the foot and ankle are twisted downward and inward.

In this type of injury, the tendon that attaches to the base of the fifth metatarsal may stretch and pull a fragment of bone away from the base. Since the fragment is pulled away from the rest of the bone, this type of injury is called an avulsion fracture.

X-ray shows an avulsion fracture at the base of the fifth metatarsal (arrow).

An avulsion fracture is also sometimes called a “ballerina fracture” or “dancer’s fracture” because of the pointe position that ballet dancers assume when they are up on their toes.

A Jones fracture is a horizontal or transverse fracture at the base of the fifth metatarsal. It is one of the most common fractures of the foot and has unique characteristics that make it more likely to require surgery.  

Treatment

Most fifth metatarsal fractures can be treated with weight bearing as tolerated, and immobilization in a cast or walking boot. If an avulsion fracture results in a large displaced fracture fragment, however, your doctor may need to do an open reduction and internal fixation with plates and/or intramedullary screws.

The appropriate treatment depends on the location of the fracture, the amount of displacement (shifting of the two ends of the fracture), and activity level of the patient.

Because Jones fractures are located in an area with poor blood supply, they may take longer to heal. In some cases, a Jones fracture may not heal at all, a condition called nonunion. When this happens, surgery is often required. Concerns with delayed healing and/or high activity demands may result in your doctor recommending surgery for an acute Jones fracture as well.

(Left) X-ray shows a Jones fracture at the base of the fifth metatarsal (arrow). (Right) An intramedullary screw has been used to hold the bone in place while it heals.

Healing of a broken toe may take 6 to 8 weeks.

Metatarsal fractures usually heal in 6 to 8 weeks but may take longer. Your doctor will take follow-up X-rays to make sure that the bone is properly aligned and healing. Even with proper healing, your foot may be swollen for several months, and it may be hard to find a comfortable shoe.

Your doctor will tell you when it is safe to resume activities and return to sports. If you experience any pain, however, you should stop your activity and notify your doctor. Returning to activities too soon can put you at risk for re-injury.

To Top

Fractured finger in a child. What is a finger fracture in a child?

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

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

ICD-10

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

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

General

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

Fractured finger in a child

Causes

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

Pathogenesis

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

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

Symptoms

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

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

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

Complications

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

Diagnostics

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

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

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

Treatment of a broken finger in a child

Conservative therapy

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

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

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

Surgical treatment

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

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

Forecast

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

Prophylaxis

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

You can share your medical history, what helped you in the treatment of a broken finger in a child.

Sources

1. To the treatment of fractures of metacarpal bones and phalanges of fingers in children (review article) / Akhmatov M.R., Tusunov B.R., Zolotova N.N.// Young scientist – 2015 – No. 2.
2. Outpatient traumatology of childhood / Adundov A.A. – 1977.
3. Pediatric surgery / Isakov Yu.F., Razumovsky A.Yu. – 2014.
4. Pediatric surgery in lectures / Kudryavtsev V.A. – 2007.
5. This article was prepared based on the materials of the site: https://www.krasotaimedicina.ru/

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

symptoms, first aid and treatment

A finger fracture is a common injury. It appears as a result of a fall, injury or safety violation. It is impossible to self-treat a fracture, because complications may arise that will affect functionality and appearance. The most common fracture occurs in the little finger, because the bones of this finger are the thinnest.

Types of injury

Injuries to the main, middle, terminal phalanx or several at once are possible. Fractures are:

1. Open.
2. Closed.

When closed, the skin is not injured, when open, there is a wound on the skin, and part of the bone sticks out. Open finger fractures are less common than closed ones and are often associated with workplace safety violations.

The position of bone fragments determines whether there is a displacement. There are also subperiosteal fractures, but they occur only in children, because in adults the periosteum is no longer so soft. Such an injury is more difficult to identify, but it heals faster.

Characteristic symptoms

You need to know how to identify a fracture yourself. To do this, you need to study the main signs of this injury. The first symptom is acute severe pain in the injured phalanx. Then swelling will appear in the area of ​​the fracture. There will also be bruising, because the broken bone injures nearby blood vessels. The victim will not be able to move the injured finger and bend it.

If misalignment occurs, visually the finger will become crooked. For example, the nail phalanx will bend to the side. When the thumb is fractured, the entire hand can be deformed. This happens if the fragment is displaced far into the soft tissue of the hand.

Another characteristic symptom of this injury is numbness and tingling. They occur due to the fact that the fragments compress the nerve or cause irritation.

First Aid

The first thing to do is to give the victim medicine that will relieve pain. For example, Analgin or Ibufen. Beforehand, it is important to clarify the presence of allergies or contraindications. If the fracture is open or there is a wound on the skin, you need to treat the finger with an antiseptic so that the infection does not enter the body. You can use iodine or hydrogen peroxide.

Apply an ice pack to reduce swelling. It is important to prevent frostbite. After 10 minutes, the compress should be removed for 2 minutes, and then applied again. You can use any frozen product, after wrapping it in a bag or handkerchief.

Do not self-set a displaced fracture while attempting to correct an abnormal finger position. In this way, muscles or tendons can be damaged. You have to wait for the ambulance.

Before they arrive, it is important to immobilize the broken phalanx and all joints of the finger. You can use a pen or an ice cream stick. If there is no suitable object nearby, tie the injured finger to the adjacent one.

Reassure the casualty. He should not try to move his finger or hand, because this will cause pain and aggravate the situation. The hand should be held above the level of the heart. This will reduce swelling and help stop bleeding if there is a wound. In case of severe bleeding, a tourniquet should be applied, remembering exactly the time when this manipulation was performed, because arteries should not be clamped for more than 2 hours. Otherwise, tissue death will begin, and the finger will have to be amputated.

Watch this video on YouTube

Treatment

After the doctor examines the injured limb, makes an x-ray and makes a diagnosis, reposition will be performed. During this procedure, an anesthetic will be injected into the finger, and then the fragments will be returned to such a position that the bone heals properly.

The upper limb must then be immobilized. The doctor will apply a cast so that the distal phalanx touches the palm. The finger must be in a bent position, otherwise re-displacement may occur. For 2-3 days, the patient should keep the hand above the heart to avoid swelling. In case of fracture of the thumb, plaster is applied to the hand to the middle of the forearm.

When the fracture is open or the bone inside is split into several pieces, surgery is necessary. Also, indications for it are incorrectly fused fractures or complications that can occur if the injury is not diagnosed on time or not treated. The operation is performed under general anesthesia.

In order for the bones to heal properly, the Ilizarov apparatus is needed. In this case, the patient, in addition to painkillers, will be prescribed drugs that will have an antibacterial effect and relieve inflammation. Bone fixation devices are removed after 3-4 weeks or remain permanently in the finger. It depends on the nature of the fracture.

Patients with non-displaced closed fractures wear a cast for 2–3 weeks. If the fracture is complex and the bone is crushed, the plaster will be removed only after 8-10 weeks.

In order for the fracture to heal faster, you must follow all the doctor’s recommendations. It is also worth adding foods that contain calcium to the diet. For example, cheese, cottage cheese, milk, almonds, hazelnuts, beans and broccoli.

Rehabilitation and recovery

Rehabilitation after a fracture is needed in order to develop a finger. You can restore his previous mobility with the help of a set of exercises that an orthopedist should prescribe. It is important to restore fine motor skills. For example, you can sort out small items:

• rice grains;
• buckwheat;
• beads;
• buttons;
• beads.

You must take them in your hand or pinch them between your fingers, and then transfer them from one saucer to another.

Another good exercise for restoring fine motor skills is clay modeling.