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Toe Fracture

(Broken Toe; Fracture, Toe)

Definition

A toe fracture is a break in a toe bone. The bones in the toes are called phalanges.

The Phalanges of the Foot

Causes

A toe fracture is caused by trauma to the bone. Trauma can result from:

Dropping something on your toe
Stubbing your toe
Falling down
Direct blow to the toe

Risk Factors

These risk factors increase your chance of developing a toe fracture. Tell your doctor if you have any of these risk factors:

Advanced age
Postmenopausal
Decreased muscle mass
Osteoporosis
Poor nutrition
Participating in contact sports
Not wearing shoes

Symptoms

If you have any of these symptoms, do not assume it is due to a toe fracture. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

Pain
Swelling and tenderness
Stiffness in the injured area
Inability to move toe
Bruising in injured area
Numbness or tingling in the toes
Visible deformity in the toe area
Difficulty walking (sometimes)

Diagnosis

The doctor will ask about your symptoms, level of physical activity, how the injury occurred, and will examine the injured area. Your doctor may take an x-ray of the foot, but this is not always needed.

Treatment

Treatment will depend on how serious the injury. Proper treatment can prevent long-term complications or problems with the toe joint, such as misalignment and immobility. Treatment involves:

Putting the pieces of the bone together, which may require anesthesia and/or surgery
Keeping the pieces together while the bone heals itself

Realigning the Bones

In many toe fractures, the bone is broken but the two pieces are in proper position. If the bones are out of position, the doctor will put the bones back into place. This is usually done without surgery. However, if your fracture is severe, you may need pins or screws to hold the bones in place. Each of these will require surgery. Sometimes, the joint of the toe is injured in the fracture, and severe joint injury may require surgery. Toe fractures in children may involve the growth plates. This may require that a specialist examine the fracture. Surgery is also possible. Once the bones are realigned, they need to be held in place while healing. The fractured toe may be taped to the toe next to it, or you may need a walking cast with a toe plate.

Medication

The following drugs may help reduce inflammation and pain:

Ibuprofen (Motrin, Advil)
Naproxen (Aleve, Naprosyn)
Acetaminophen (Tylenol)
Aspirin

If you have a fracture, check with your doctor before taking nonsteroidal anti-inflammatory medications.

Self-care

Rest—Do not participate in sports or activities until your toe is fully healed.
Ice—Apply ice or a cold pack to your toe for 15-20 minutes, four times a day for several days. This reduces pain and swelling. Wrap the ice or cold pack in a towel. Do not apply ice directly to your skin.
Elevation—Keep the injured foot raised above the level of your heart for 48 hours (such as on a pillow). This will drain fluid and reduce swelling.

Prevention

To help reduce your chance of getting a toe fracture, take the following steps:

Always wear well-fitted, supportive athletic shoes when doing physical activity.
Wear shoes to protect your feet.
Eat a diet rich in calcium and vitamin D.
Do weight-bearing exercises to build strong bones.
Build strong muscles to prevent falls.

RESOURCES

American Academy of Orthopaedic Surgeons http://www.aaos.org

American Academy of Physical Medicine and Rehabilitation www.aapmr.org

The American Orthopaedic Foot and Ankle Society http://www.aofas.org

CANADIAN RESOURCES

Canadian Academy of Sports Medicine http://www.casm-acms.org

Canadian Orthopaedic Association http://www.coa-aco.org

References

Eat right...your feet will thank you. The American Orthopaedic Foot and Ankle Society website. Available at: http://www.aofas.org/Scripts/4Disapi.dll/4DCGI/cms/review.html Action=CMS%5FDocument&DocID=72&Time=-1551839844&SessionID=165m17wl39o18pg5iv8824x18pfk5486y6969ylh3p586b5l537bvon251818csf . Updated January 2008. Accessed July 1, 2008.

Hatch RL, Hacking S. Evaluation and management of toe fractures [review]. Am Fam Physician. 2003;68(12):2413-2418. Available at http://www.aafp.org/afp/2003/1215/p2413.html

Ribbans WJ, Natarajan R, Alavala S. Pediatric foot fractures. Clin Orthop. 2005;(432):107-115.

Revision Information

Reviewer: John C. Keel, MD
Review Date: 09/2012 -
Update Date: 09/28/2012 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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