Most people don’t realize, but your foot is chock full of bones. In fact, you have 52 bones between the two feet. Of the 26 bones in each foot, 19 are phalanges (in the toes) or metatarsal bones (the long bones of the midfoot). Fractures (or breaks) of the metatarsal bones and toes are common. But just because they are common, doesn’t mean they should be ignored. All fractures in toes warrant an evaluation by a foot specialist, even if initial treatment has been started in the emergency room.
What Is a Toe Fracture?
A fracture is a break in a phalanx bone in the toe.
Traumatic fractures (also known as acute fractures) are caused by the application of force or trauma. This can be an impact such as a direct blow—like forcefully stubbing your toe. When evaluating traumatic fractures it is important for your doctor to determine whether the broken bone is displaced or non-displaced. In displaced fractures,the bone is not only broken, but it is also moved out of alignment. In this case it is said to be dislocated. Treatment of these types of fractures depends on the extend of injury, the amount of displacement, and whether or not the joint surface is involved. Surgery is sometimes required to put the bone back into proper position and stabilize it so it can heal.
You might have a traumatic toe fracture if you notice any of the following:
• You may hear a sound at the time of the break.
• “Pinpoint tenderness”(pain or tenderness at the precise location of injury) at the time the fracture occurs and perhaps for a few hours later. This can be deceiving, because sometimes, the pain goes away after several hours.
• Deviation or mal-alignment (crooked, misshapen or abnormal appearance) of the toe.
• Bruising and swelling that starts to appear within 48 hours of the injury.
• It is absolutely not true that “if you can walk on it, it can’t be broken.” We see about people walking into our office with fractures on a regular basis. Because of this, if you suspect you have a fracture, you should get in for an evaluation as soon as possible. We reserve slots for emergency appointments evry day so you won’t have to wait to get taken care of.
Stress fractures are very small crack in the bone. These don't usually occur in the toes.
Sprains and fractures can have very similar symptoms, but often with a sprain, a broader area of the foot will ache, rather than just a certain point of tenderness. We can easily diagnose which you have and start you on the appropriate treatment to make sure you get to your activities as fast as possible. Keep in mind that some sprains and dislocations can be severely disabling. Without the right treatment you can develop crippling arthritis.
Potential Problems of Improper Fracture Treatment
We often see people in the office who will say “I thought that there isn’t anything that can be done for a broken toe.” This is false. In fact,if a fractured phalanx bone in the toe or a metatarsal bone in the foot is not treated correctly, you can develop serious problems. For example:
• A permanent deformity in the bone alignment and structure can develop and limit the ability to walk on the foot or fit into shoes
• Arthritis is often caused by an untreated fracture that involves a break in the joint surface. In some cases, when the bone isn’t realigned, an angular deformity develops and causes problems.
• Chronic foot pain and long-term difficulties with walking
• Non-union,or failure of the broken bone to heal, can lead to a need for surgery or suffering from chronic pain.
Toe Fracture Treatment
Fractures of the toe bones are almost always causes by trauma such as a badly stubbed toe, or dropping something on the toe. Treatment for traumatic toe fractures will depend on the type of break, the extent of displacement, and whether or not the joint involved. Treatment options can include:
• Rest. Sometimes a little rest is all that is needed to treat a traumatic toe fracture.
• Splinting. The toe may be fitted with a special splint to hold it in a stable position.
• Rigid or stiff-soled shoe. Wearing a stiff shoe can protect the fractured toe and keep it properly positioned.
• “Buddy taping” the fractured toe to the toe next to it can help in some cases and hurt in others. Never attempt this unless instructed to do so by a foot specialist.
• Surgery. If the is break bad enough, or if the joint is involved, you might need surgery. In surgery, the broken bone is realigned and pinned to allow it to heel in a correct position.