Oh Those Broken Toes!

  • We’ve all done it….caught your toe on the bedpost, or dropped something on your toes. The pain can be pretty severe and a few choice words are said. You’re sure it’s broken. After a week or two, the bruising, pain, and swelling are still there. How do you tell if something is broken or not, and what should be done? Early treatment is key to these types of foot injuries. 

There are 26 bones in one foot, and 14 of these bones are classified as a phalanx bone. Two phalanx bones make up the big toe and three phalanx bones make up the four smaller toes. Unfortunately, it is rather common to break one or more phalanx bones, which is referred to as a fractured or broken toe. There are two very common causes for fracturing a toe, which include dropping a heavy weight on the toe or stubbing the toe. If a heavy weight is dropped on the toe, the phalanx bone may end up getting crushed into smaller pieces, which is why this is called a crush injury. In addition to the phalanx bone being crushed, there may be other foot bone fractures, nail and/or skin damage present. However, the most common type of fracture to the phalanx bone is called a spiral oblique fracture, which is also known as the “bedpost fracture.” The fracture gets this name because the name illustrates stubbing the toe against a bedpost, which the stubbing of the toe is what causes the phalanx bone to fracture.  So even doing something as common and simple as cleaning your home, the stubbing your toe on furniture or dropping something off a shelf can lead to a fractured toe. The following are the signs and symptoms of a fractured toe:

  • Recently stubbed or dropped weight on toe
  • Bruising and swelling of the toe soon after
  • Pain-especially with walking or wearing shoes

With any injury on any body part, the time tested acronym of R.I.C.E., or now P.R.I.C.E. should be followed and it’s no different with a injured toe. P is for protection of the injured part. Stabilizing the toe with tape, or buddy splinting is good. R is rest, or stop the activity. I is ice the affected foot and toes to help reduce the swelling. C is for compression and there isn’t much that can be done for a toe in this instance. If there is an injury to the foot, then wrapping the foot in an ace wrap is beneficial. E for elevation–get the foot elevated above the level of the heart. These steps help reduce the complications of injuries. Seek immediate medical attention if the toe becomes discolored or if there is persistent numbness.  Fractured toes are often ignored or people believe that there is no treatment. Some people also believe that the toe is not fractured if it can still be moved, but this is incorrect. The only way to truly diagnose a fractured toe is by taking an x-ray of the foot. Once the x-ray shows which toe or toes are broken, treatment can begin. It is important to treat fractured toes to ensure that the fracture heals with the toe in proper alignment. Not only would mal-alignment make the healed toe look different from the rest, but it may also cause constant long-term pain, stiffness, or arthritis.

There are two common ways to treat a fractured toe while aiding the toe to heal in proper alignment. The first method is by using a specific method of taping, which is called buddy taping. Buddy taping the toe will hold the toe in proper alignment while the bone is healing. The second method is by immobilizing the foot with a cast or a hard-soled surgery-type shoe, which will keep the foot from moving while walking, which will decrease the stress on the toe. This method will allow the bone to heal with out being disturbed by movement, as well as the patient being able to avoid using crutches. The buddy taping and immobilization methods may be used separately or alone for the treatment of a toe fracture. Depending on the severity of the fracture the bone will need 6-8 weeks to heal. So it is important to have an x-ray sooner rather than later, so if the toe is broken, the toe can be positioned in proper alignment to allow the bone to heal correctly.

 

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