Broken Toe / Foot

Broken Big Toe, Pinky / Little Toe  Fracture Management

 

A broken toe can be painful and it usually occurs when you stub yourself while walking barefooted, or when you drop something heavy on your toes. The injury is usually not that serious and is a mild sprain only. This condition is painful, but the bone remains intact. If the bone breaks then you have a fractured toe. Normally, it takes a lot to break a bone but the toes are very fragile. They are also more likely to be injured as they are located at the peripheral extremities of your body and are more exposed to the dangers of the external environment.

Prolonged, repetitive, and forceful foot movements can also result in this problem and the fracture of this type is called “stress” or “hairline” fracture. It is a common finding among athletes who take part in high-intensity contact sports i.e. hockey, soccer, and football.

 

Common Causes of Broken Toe

The following are the most common causes of broken toes:

1.    Dropping a heavy object on your feet

2.    Stubbing your toe against the sides of the furniture

3.   Wearing poor quality shoes

4.    Compromised bone health (e.g., in osteoporosis)

5.    Rolling your toes

6.    Trauma due to unforeseen accidents

 

Symptoms or Signs of a Broken Toe

It is quite common to ignore an injured toe and if this happens, you are at risk of improper healing that can hinder the performance of your daily activities. So, it is best to know what a broken toe looks like and how the problem can be resolved. The symptoms of a broken toe are similar to a sprain and include the following:

1.    Difficulty to ambulate

2.    Swelling and bruising around the affected toes

3.    Toe discoloration

4.    Visible deformity in the toes, such as a bone exposed outside the skin

5.    Intense throbbing pain

6.    Redness (erythema) of the toe

7.    Profuse bleeding

8.    Tingling of the affected area

9.    Injury of the involved nail beds

 

Fractures of Big Toe

Big toe fractures are often found in athletes due to their highly active and demanding routine. The fractures are often due to repetitive movements while running, jumping, or sprinting. These breaks are called “turf toes”. They vary from fractures to avulsed ligaments. These fractures occur several months or years after actively starting a new activity such as running since they are usually due to joint overuse.

 

Fractures of Little Pinky Toe

The pinky toe is the most commonly injured of all toes. It is highly prone to injury as it is positioned most laterally in the foot. The fracture mostly occurs at its base. This is most often a result of stubbing the toe against the furniture when walking barefooted in your home.

 

Treatment of Broken Toe

1.    First Aid

The first thing to do when you face an injury to your toes is to follow the “RICE protocol”. It is a universal rule in the first-line treatment of every fracture. The steps include the following:

a.              Rest. Avoid putting stress on the fractured foot and limit the movements.

b.           Ice Packing. Place ice packs on the swollen area which will effectively reduce the pain and prevent any further inflammation.

c.              Compression. External pressure is applied on the toe by wrapping it tightly with a cloth or a bandage.

d.             Elevation. Raise the foot higher than the chest to decrease the blood perfusion of the foot and minimize the toe swelling.

Also, the patient can take over-the-counter anti-inflammatory medications if they are not already contraindicated according to the health status of the individual. The use of crutches is also advocated to prevent any undue stress on the broken foot.

2.    Buddy Taping

The most common non-surgical treatment of a broken toe involves splinting it with the adjacent non-broken toe. This technique is called “buddy taping”. The fractured toe is stabilized as the non-broken toe serves as a splint. This gives ample support to the healing toe and remarkably lessens the recovery time.

3.    Walking Shoes

Using walking or medical boots help to offset any pressure on the injured area. They provide a cushion against subsequent injury from bumping into different objects and keep the fractured toe in a stabilized position. They are mostly advised by physicians when surgical intervention is not needed as they can hasten the recovery process efficiently.

4.    Surgical Intervention

If the fracture is severe and involves dislocation and breaks at multiple points then surgery is the last resort. Surgery is also needed for metatarsal fractures. The technique involves manually putting the bone back into position with the help of screws, nails, or wires. This is called “closed reduction” of the fracture. The injured toe usually takes 6-8 weeks to heal properly, and the patient can freely return to work after this period.

Complications if the Broken Toe is left Unattended

It is necessary to take adequate care of the fracture with the advice of a physician as soon as possible. If not then the following complications are bound to occur:

1.    Osteomyelitis. The breaks in the overlying skin may allow the entry of bacterial pathogens which can infect the bone. These infections can be life-threatening and need a strong anti-bacterial cover for treatment.

2.    Permanent Deformation. A deformity can change the appearance of the toe as a whole, and may even cause difficulty and discomfort while wearing shoes and walking.

3.    Chronic Pain. Improper healing disturbs the anatomy of the whole foot and may cause awkward fusion of the broken segments. The pieces may impinge on the local neurovascular structures and maybe a source of continuous pain for years after the injury.

 

Preventing Damage to the Toes

Following strategies should be adopted to prevent any harmful toe injury:

1.    Wearing proper and quality shoes.

2.    Ensuring a proper diet replete with calcium and vitamin D.

3.    Performing regular physical activity and exercises strengthening the muscles of the feet.

4.    Avoid walking barefooted and instead, use non-protective shoes such as sandals and flip flops.

5.    Replacing the footwear when they begin to wear out. This should be especially followed by athletes who need to change their shoes after every 6-8 months.

6.    Keeping diabetes in check as it leads to a loss of sensory innervation in the feet and may result in unintentional damage to the toes.