Broken Toes

Broken Toe

Broken Toe Overview

Another name for a broken toe is a toe fracture. Each toe is made up of several bones. One or more of these bones may be fractured after an injury to the foot or toes.

Broken Toe Causes

Broken toes usually result from some form of trauma or injury to the foot or toe. Injuries such as stubbing a toe or dropping a heavy object on a toe may cause a fracture. Sometimes a broken toe may result from prolonged repetitive movements, as in certain sports activities. This is called a stress fracture.

Broken Toe Symptoms

• After the injury, pain, swelling, or stiffness will occur. Bruising of the skin around the toe may also be noticeable. The toe may not look normal, and it may even look bent or deformed if the broken bone is out of place. It may be difficult to walk because of the pain, especially if the big toe is fractured.
• Shoes may be painful to wear or feel too tight.
• A doctor may take an x-ray film to see if a toe is broken, but x-ray films are not always necessary if the fracture is in one of the smaller toes.
• Some other problems may develop in addition to, or as a result of, the fracture. These complications can occur right away after the injury (minutes to days), or can happen much later (weeks to years).
  
  
  • Immediate complications
    
    
    • Nail injury: A collection of blood may develop underneath the toenail called a subungual hematoma. If it is large, it may have to be drained. To drain a subungual hematoma a doctor will make a small hole in the toenail to drain the blood out. If the hematoma is very large or painful, the entire toenail may need to be removed.
    • Open fracture: Rarely, the broken bone in a toe fracture may stick out through the skin. This is called an open or compound fracture. Careful cleansing of the wound and possibly antibiotic medication will be needed to prevent the bone from becoming infected. Sometimes surgery may even be necessary.
  • Delayed complications
    
    
    • After the toe fracture heals, the person may still be left with arthritis, pain, stiffness, or even a deformity.
    • Sometimes, the fractured bone will not heal completely (called a nonunion), or will heal improperly (called a malunion). Rarely, surgery may be necessary to fix this problem.

When to Seek Medical Care

The injured toe should be looked at every day. Call a doctor if any of the following occur:

• Worsening or new pain not relieved by pain medication and the measures described in the treatment section
• Sores, redness, or open wounds near the injured toe
• A cast or splint is damaged or broken

Go to a hospital’s emergency department if the following signs or symptoms are present:

• Cold, numb, or tingling toes
• Blue or gray colored skin
• Open wounds, bleeding, or drainage from near the broken toe.

• Exams and Tests

  A doctor will ask some questions to determine how the toe was injured. Then the doctor will examine the injured toe and should also make sure there are no other injuries.
  It is best to seek medical evaluation soon after the injury to ensure proper treatment and healing.
  • A doctor may take an x-ray film to see if a toe is broken or fractured.
  • X-ray films are not always necessary to make the diagnosis of a broken toe, especially if the break is in one of the smaller toes.

  Broken Toe Treatment Self-Care at Home

  These are things that can be done at home to help decrease the pain and swelling and to help the fracture heal properly.
  • Elevation
    
    
    • Swelling that occurs after the injury worsens pain.
    • To decrease the swelling (and the pain), keep the foot raised above the level of the heart as much as possible.
    • Prop the foot up on some pillows, especially when sleeping. Reclining in a lounge chair is also helpful.
  • Ice
    
    
    • Put ice in a plastic bag and apply it to the injury for 15-20 minutes every 1-2 hours for the first 1-2 days.
    • Make sure to place a towel between the skin and the bag of ice to protect the skin.
  • Rest
    
    
    • Avoid any strenuous exercise, prolonged standing, or walking.
    • Crutches may be needed, or a special shoe to wear when walking to avoid putting weight on the fracture while it heals.

  Medical Treatment

  Depending on the location and severity of the toe fracture, the fracture may need to be reduced (put back into place) and splinted or casted. If there is an open wound near the injured toe, a tetanus shot and antibiotic medication may also be necessary.

  Medications

  Pain medications
  • Usually only acetaminophen (Tylenol) or ibuprofen (Motrin) is needed for pain.
  • Talk to the doctor before taking any new medications.
  • For a severe fracture, the doctor may prescribe something stronger.
  • Pain will be helped by elevating the foot and using ice packs.

  Other Therapy

  • Reduction
    
    
    • If the toe fracture is displaced (the 2 ends of the broken bone are out of place) or rotated (the toe is pointing in the wrong direction), the doctor may need to reduce it, or put it back into place.
    • Sometimes a shot of medication (called local anesthesia) may be needed to numb the toe before it is put back into place.
    • After a reduction, the broken bone will need support to hold it in place while it heals.
  • Buddy taping
    
    
    • If the toe fracture is a minor or small fracture in a bone of one of the small toes, a doctor may only need to tape the injured toe to the one next to it for support. This treatment is also called buddy taping.
    • If the toe is buddy taped, it is usually safe to bathe, and then replace the tape afterward, but check with the doctor to make sure it is OK.
    • If the tape is replaced by the person with the toe injury, they should make sure to put a small piece of cotton or gauze between the toes that are taped together. This prevents the skin between the toes from developing sores or blisters.
  • Casting
    
    
    • A cast is usually not required for a simple toe fracture.
    • A hard-soled, sturdy, and supportive shoe should be worn.
    • A doctor may give a special shoe to wear if the foot or toes are very swollen.
    • A cast (or even surgery) may be needed if the big toe is broken, a fracture involves a joint, or a lot of small toe fractures occur at once.
    • A cast may also be needed if a bone in the foot or leg is broken in addition to the toe.
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    • Next Steps Follow-up

      Talk to the doctor to find out when to schedule an appointment to have the injured toe evaluated to make sure it is healing properly. If any problems or complications develop sooner, the appointment should be scheduled sooner.

      Prevention

      To help prevent an injury resulting in a broken toe, sturdy and supportive shoes should be worn.

      Outlook

      Broken toes usually take about 6 weeks to heal. If problems last longer than 6 weeks, another x-ray film may be needed, or the injury should be rechecked by the doctor to see how the bone is healing.
      Simple fractures usually heal well with no problems. However, a very bad fracture or a fracture that goes into a joint is at risk for developing arthritis, pain, stiffness, and possibly even a deformity.