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Broken Toe

Broken toes are one of the most common breakages to occur in the human body. This is in part due to the fact that they are comprised of a series of small bones and in part because they are so frequently used and abused on a routine basis. Though the toe bones are small when fractured or broken it can be quite uncomfortable and frequently even immobilizing. It is often inconvenient as well, as it can take four to six weeks for a break or serious fracture to heal. If the break or fracture is severe enough recovery may take even longer, especially if the use of a cast is needed or if surgical intervention is required.

Diagnosing a broken toe can be difficult as it is not always clear if the toe is broken, fractured, or superficially injured. This is especially true since breaks are often the result of such common occurrences as jamming or `stubbing` the toe or having a heavy object fall on the foot, thereby injuring the toe. The symptoms of a break, fracture, or superficial injury look and feel very similar to one another. The best course of action is to have the toe examined by a professional if symptoms persist beyond two or three days or are serious enough to impede the wearing of shoes, walking comfortably, or if pain is severe.

Broken Toe: Symptoms

Commonly occurring symptoms of a broken toe are as follows:
• Pain
• Swelling
• Tenderness
• Bleeding
• Bruising of the toe
• Deformity of the toe
• Weakness in the toe
• Inability to bear weight on the toe
• Should numbness, tingling and/or paralysis in the area of the fracture occur seek immediate medical attention.

Broken Toe: Diagnosis

When diagnosing a broken toe your doctor will ask you how the injury occurred, which symptoms are present, and what type and intensity of physical activity you generally undertake. These questions will be followed by a physical examination of the toe, including an assessment of any damage to the nail bed or surrounding tissues. Your doctor may order an x-ray in order to better examine the extent and/or severity of the break or fracture. An MRI (magnetic resonance imaging) scan or CT (computed axial tomography) scan may also be ordered if your doctor suspects the surrounding tissues have been injured. Once the extent of your injuries has been confirmed your doctor will implement an appropriate treatment plan.

Broken Toe: Causes

Broken toes typically occur due to sudden injury, such as stubbing or jamming the toe, though it can also occur over the long term due to repetitive stressors. This type of injury is most often seen in dancers and athletes as sports and dance require frequent jumping, accelerated stopping and starting motions, and rapid changes in direction of movement. An acute fracture of the toe may also result from the impact of a heavy object falling on the foot.

Broken Toe: Complications

Broken toes are very common and not usually cause for concern, though complications can arise. It sometimes happens that a subungual hematoma develops, which means that blood has begun to pool beneath the toe nail. Should the hematoma be large or excessively painful your doctor may choose to drain the fluids. While initially painful it reduces pressure and discomfort both immediately and over the long term. Loss of the toe nail often occurs following drainage of the fluids.

Should the breakage fail to fully heal (nonunion) or to heal properly (malunion) surgical intervention may be required to remedy the injury. Even in when broken toes heal without complications arthritis or osteoarthritis may eventually develop in the affected toe. Both conditions are typically painful and may lead to stiffness of the joint or deformity of the toe.

Broken Toe: Treatment

There are various ways to treat a broken toe. Treatment methods typically depend on the type and severity of the injury. Some aspects of treatment can be performed by the patient while others require a foot doctor or podiatrist. The RICE method—Rest, Ice, Compression, Elevation—is one of the most common home remedies used to treat broken toes as well as a variety of a leg and foot injuries as it is effective in reducing pain and swelling. If the break is severe the toe may need to be reset or put back into place through the use of a splint or cast. If the broken bone cannot be properly reset—if the bone pieces cannot be properly matched a reduction may be needed to remedy the situation. The procedure is non-invasive and does not require an incision to be made though it may cause some discomfort. The patient may also be required to use crutches for up to three weeks if the break or fracture is severe.

Although less common, some foot doctors will recommend wearing a stiff-bottomed shoe during recovery in order to protect the toe from bending. Buddy taping is, however, a much more common technique for stabilizing an injured toe. This requires taping the injured toe to a healthy adjacent toe for support and stability. A tetanus or antibiotic shot may be required to prevent infection from occurring, but only if there are open wounds on or around the affected toes.

Over-the-counter painkillers such as ibuprofen are commonly recommended to reduce levels of pain and swelling. A prescription painkiller is usually only issued in cases where the breakage is severe and perhaps in need of surgical intervention. In this instance it will likely be your treating podiatrist of foot surgeon who performs the procedure in order to realign the bone ends for proper healing. Pins, plates, and/or screws are often used to ensure proper realignment of the bones and toe. A splint or cast is frequently used post-surgery to ensure proper setting of the bone.

The best outcomes are usually seen in children, as they tend to heal fully and quickly whereas elderly patients typically do not experience the same degree of recovery. The time frame for recovery depends on both the type of break and the extent of tissue damage to the immediate and surrounding areas. While some patients are fully recovered after six to eight weeks some patients may take as long as six months to fully recover.

Broken Toe: Prevention

Broken toes are typically the result of unforeseeable accidents but there are several precautions that can be taken to reduce the risk of injury:

• Wear well-fitted shoes at all times.
• Wear shoes that cover and protect the toes, especially at work and when participating in physical activity.
• Reduce the risk of tripping or falling at work and home. Unanchored rugs, loose stair railings, and random items such as toys left on the floor all increase your risk for accidents.
• When treating medical conditions such as osteoarthritis follow your treatment plan to maintain health and protect fragile bones.
• Be very attentive when participating in high-impact activities or activities that require rapid changes in direction.
• Make sure your Vitamin C and zinc intake is sufficient as they help promote bone strength and increase healing times.
• Seek medical attention if you suspect a break or a fracture.

What to Ask Your Doctor about Your Broken Toe

If you wish to learn more about this condition here are a few questions your foot doctor or podiatrist will be able to answer:
• What is the best type of shoe for me based on my activities and activity level?
• How long should I wait before returning to my usual activities and activity level?
• If non-invasive treatment methods are not effective how long should I wait before making another appointment?
• What symptoms should indicate that complications are developing or have occurred?
• How often may I shower while wearing a cast?
• What is the best way to wash my toe during the healing process?

Broken Toe: Conclusion

Broken toes are generally not cause for concern but like any foot injury should be diagnosed and treated by a foot doctor or podiatrist to ensure proper healing.



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