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When someone stubs their toe or drops an object on it, it’s common to question whether the toe is broken or bruised. It’s important to address broken toes appropriately and not overlook them.
This article will discuss the causes, symptoms, diagnosis and treatment for toe fractures and why it’s important to keep treatment promptly.
What Causes a Broken Toe?
A broken toe is a fracture in one of the bones of the toes. Most toe fractures are caused by an axial force (e.g., a stubbed toe) or a crushing injury (e.g., from a falling object), according to R. Hatch in the American Family Physician.
However, fractures can happen due to overextension or flexion of the toe joints during activities. Activities that require frequent pressure to be placed on the toes like running and ballet can cause a toe stress fracture.
Toe fractures account for about 8% to 9% of all fractures, as highlighted by P. Eiff in Fracture Management for Primary Care and Emergency Medicine.
The big toe contains two bones, while the second to fifth toes each have three bones.
The toes contain a variety of tendons and ligaments that play important roles in foot mobility and stability.
On top, “extensor tendons” aid in lifting the toes during walking. On the bottom, “flexor tendons” aid in the downward movement of the toes. Additional tendons that attach to the sides of the toes are responsible for spreading the toes apart. Ligaments in the toes provide support to the joints.
Understanding these structures is important for treating toe fractures because a broken toe can be accompanied by dislocations or tendon injuries. Such complications can influence the toe’s future healing process. Toe fractures should not be confused with metatarsal fractures (which are fractures of the metatarsal bones).
What Are the Symptoms of a Broken Toe?
The symptoms indicating a broken toe are listed below.
Swelling/Bruising: Following a toe injury, immediate swelling and bruising may appear, a consequence of damaged blood vessels within the toe. The affected toe may present shades of blue or purple.
Subungual Hematoma: This condition is characterized by blood accumulation beneath the toenail, resulting from toe trauma. The presence of a subungual hematoma can be a clue that the toe might be broken.
Pain: A broken toe might produce a dull, achy sensation. Additionally, sharp and tingling pain can arise, often linked to nerve irritation within the toe.
Alignment Issues: If dislocated, the bones may appear shifted or even rotated. Such an injury can hinder one’s ability to wear shoes comfortably. One way to check is by examining the toenail’s orientation. If it isn’t facing upwards as it should, the underlying bone could be broken.
Difficulty in Bending the Toes: While slight movement might still be possible with a broken toe, bending can become notably challenging. Fracturing a toe might also impact the tendons. This will restrict its mobility.
How Does a Health Care Provider (Foot and Ankle Doctor) Diagnose a Digital Fracture?
When diagnosing a digital fracture, a health care provider (Foot ankle surgeon) takes several key steps. First, the alignment of the toe is examined. If the broken bone pieces aren’t lined up correctly, it might indicate complications in the healing process.
The surgeon’s assessment will determine whether there’s a need for fracture reduction, which is the realignment of the broken bone.
How Are Broken Toes Treated?
When someone suffers a broken toe that remains in an approximately correct position without the need for surgery, a common treatment method recommended by doctors is “buddy taping.”
To execute this, one should place cotton or gauze between the injured toe and its neighboring toe. Adhesive cloth tape or Coban, which is preferred for its comfort and swelling reduction capabilities, can be used to secure the toes together.
Here is a visual guide by Richard Blake on how to properly buddy tape a toe:
It’s essential to avoid taping the toe tips, as this might cause the injured toe to rotate.
Doctors often advise wearing a surgical cast shoe for 3-4 weeks to minimize toe movement. This footwear can be found on platforms like Amazon.
Excessive movement can lead to the shifting of fracture fragments, potentially necessitating surgical intervention.
To aid recovery, patients should rest and ice their foot, ensuring the icing doesn’t exceed 20 minutes every hour. Elevating the foot on a couple of pillows can help reduce swelling. Your medical doctor will prescribe pain medicine to keep pain under control.
If the fractured fragments have shifted from their original position, realignment might be needed. This procedure, often done in a doctor’s office, involves a local anesthetic being injected into the toe to numb it, followed by the doctor realigning the fracture.
Afterward, x-rays are taken to confirm the alignment, and the toe is splinted in the right position. Walking in a surgical cast shoe for several weeks is typically recommended post-procedure.
In instances where the fracture can’t be realigned without surgical intervention, especially concerning the big toe, surgery might be warranted. The big toe plays a significant role in walking balance and push-off.
If there’s damage to important tendons, surgery might be the best course of action. In some cases, tendons or ligaments might get trapped between the fracture fragments, complicating a straightforward realignment.
Under such circumstances, the doctor may suggest an open reduction with internal fixation of the toe in an operating room setting. Here, the fracture is repaired using tools like a K-wire or mini-screws.
After the operation, wearing a cast boot for a minimum of 4-6 weeks is standard procedure.
What Is the Recovery Process Like After a Digital Fracture?
Recovery from a digital fracture varies based on the severity of the fracture and the specific toe affected. Generally, the healing period ranges from 4 to 8 weeks. Factors that might extend this duration include the presence of a comminuted fracture (where the bone breaks into multiple pieces) or if the patient has a history of smoking, which is known to hinder bone healing.
A fractured toe, if not treated appropriately, can lead to various complications as listed below.
- Poor Alignment: When the broken toe doesn’t heal in its correct position, it can lead to lasting discomfort and appearance concerns.
- Arthritis: A fracture that extends into the joint can increase the risk of developing arthritis in that toe.
- Chronic Pain: Untreated or improperly treated fractures might result in persistent pain in the affected toe.
- Deformity: Healing without proper alignment can cause the toe to look deformed or bent.
- Limited Mobility: Scar tissue or improper healing can restrict the toe’s movement or flexibility.
- Infection: Especially if there’s an open wound, there’s a risk of the toe becoming infected.
Remember, early and appropriate treatment can minimize the chances of these complications from occurring.
How Do You Know if a Digital Fracture Is Healed?
The absence of pain often suggests that the toe is healing or has already healed. However, the most definitive method to determine the healing of a broken toe is through an x-ray. Regular x-rays, typically every 4 weeks, are crucial to monitor the bone’s healing progress and to ensure that the fracture fragments remain in place throughout the recovery period.
Should a Broken Toe Still Hurt 1 Month Later?
It’s not uncommon for a broken toe to continue experiencing pain during its healing phase. Given that the bone typically requires 4-8 weeks to mend, some level of discomfort can persist. This might manifest as a lingering dull or achy sensation. If the fracture isn’t addressed adequately, pain might endure for extended periods, potentially months or even years, due to issues like malalignment and the onset of arthritis.
What Activities Can You Do After a Digital Fracture?
Following a toe fracture, it’s essential to prioritize rest and refrain from high-impact activities like running for at least a month. Engaging in actions that place undue pressure on the toe could exacerbate the injury.
However, with a physician’s clearance, certain low-impact activities may be allowed.
These activities are listed below.
- Swimming: This provides a full-body workout without putting pressure on the toes.
- Walking: Ensure to walk with care, avoiding any activity that might stress the broken toe.
- Leisure Biking: If the toe is securely buddy-taped and one wears shoes with a rigid sole, biking can be considered. This is typically suitable for those with a mild, non-comminuted fracture.
Can You Work With a Broken Toe?
Whether one can return to work after sustaining a toe break depends on thenature of their job. For those engaged in roles that predominantly involve sitting, such as desk jobs, it’s typically possible to get back to work. While at the desk, it’s beneficial to elevate the foot to help mitigate swelling.
However, for those in physically demanding professions that require extensive walking, a consultation with a physician about any potential work restrictions is important. This becomes especially pertinent for those who’ve undergone surgery or are currently relying on pain medications during their recovery phase.
It’s worth emphasizing that driving or operating machinery while on narcotics is not recommended.
How Can You Prevent Digital Fractures?
To prevent broken digits, individuals should exercise caution in their daily activities. This includes wearing appropriate footwear that offers protection and support, especially in environments where there’s a risk of dropping heavy objects. Regularly clearing living and working spaces of clutter can minimize tripping hazards. Engaging in strength training and balance exercises can also enhance foot stability and reduce the risk of traumatic injuries to the toes.
This review underscores the importance of thorough toe care, highlighting the dire consequences of overlooking even seemingly minor issues, such as a bruised toe. Through extensive research, we’ve illuminated the broad topics associated with toe health, ranging from care instructions to understanding stress fractures.
The services of medical professionals in this area are invaluable. When faced with a break or any other toe-related ailment, promptly consulting a doctor and receiving the appropriate services ensures that fractured toes receive the correct attention. Ensuring optimal health in such situations necessitates listening to professional advice and accessing the right resources.
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