Patient Education

Broken Toe

Description

If anyone has ever told you that broken toes are untreatable and there’s no reason to go to all the trouble of seeing a doctor, they are, frankly, completely wrong. It’s an excellent idea to consult your podiatrist whenever you injure your foot, particularly if you suspect a break. Many fractures of the toe can be treated. Depending on the severity of the break, many may respond to conservative treatment, but some might be serious enough to require surgery. Failing to get proper treatment may result in improper healing of the fracture. Deformity in the toe or foot might follow, making it more difficult to wear shoes comfortably, and reducing the function of your foot. Improper healing may also cause arthritis, or other long-term pain. In short, talk to your podiatrist. He or she will be able to ascertain the most effective way to treat your particular broken toe.

There are a couple of different kinds of breaks you should know about. One type of break is a traumatic fracture, which results from a particular event, such as stubbing your toe on that wretched enormous dresser in the middle of the night, or possibly dropping an armful of bricks on your foot. (Armfuls of feathers usually don’t do quite so much harm.) This type of fracture may be displaced (the broken bone has shifted from its proper position) or non-displaced (the bone is cracked, or even broken through, but it hasn’t moved from where it’s supposed to be).

Another type of break is a stress fracture, which occurs when repeated strain is put on a bone, resulting in small breaks that develop over time. Athletes who precipitously increase their activity (particularly runners), people with osteoporosis, and those who have abnormalities in the structure of their feet may be most susceptible to this type of fracture.

Symptoms

The symptoms of traumatic and stress fractures are similar in some ways and different in others. With both types, fractures tend to be painful in one specific spot (aka pinpoint pain). (If you find that your pain is more general, you may have experienced a sprain rather than a fracture. However, it’s still a good idea to get the injury checked out, since sprains can be serious business as well.) You may be able to walk around even after breaking a toe, so don’t assume you haven’t broken it just because you’re still mobile.

A few symptoms are a little different between the two types. For instance, traumatic fractures tend to be associated with swelling and bruising, while stress fractures usually exhibit swelling alone. You may also get abnormalities in the shape of the toe or foot with traumatic fractures, and sometimes people actually hear a snapping noise at the time the fracture occurs. Pain from stress fractures may go away while you rest, then reappear when you begin to use your foot again, or just after use.

Diagnosis

Your podiatrist is darn good at figuring out what’s wrong with your foot. When you go in with a suspected break in your toe, he or she will likely perform a physical examination, checking the toe for tenderness and pain. In order to make a more firm diagnosis, your podiatrist will probably order X-rays of your toe, or may use other imaging technology.

Treatment

When your podiatrist has confirmed that your toe is broken, he or she will discuss treatment options with you. Treatments vary widely depending on the type and severity of the break. For instance, with some very minor fractures, it may only be necessary to remain off of the toe as much as possible. This is often accompanied by padding the toe and wearing shoes that don’t put any pressure on it (such as open-toe sandals).

The key to proper healing of breaks is immobilization. To achieve this, your doctor may choose to splint the toe, sometimes by taping the broken toe to an adjacent unbroken one. However, not all toe breaks work well with this type of treatment, so don’t try to do it yourself (especially if you decide to use that clear tape-let’s not be silly, folks). Your podiatrist will also put padding in between the taped toes, so the skin won’t rub together and create problems. Artificial splints may also be used.

If splints aren’t likely to do the trick, you may get a cast to keep your toe from moving around during the healing process. (But hey-remember that casts also double as a wonderful canvas for doodling and well-wishes in felt pen.) Your podiatrist may also recommend a stiff-soled shoe, (especially after surgery), which keeps the toe from moving about as you take steps.

If the bones are dislocated (i.e. out of place-these are the wanderers of the broken bone world), your podiatrist may need to realign the bones (aka reduction) in order to get the right pieces to knit together with the other right pieces. Sometimes he or she will be able to manipulate the bones without surgery. However, especially with particularly bad breaks, surgery may be needed to keep all the pieces of your broken bones together as they heal. Surgery often involves placing pins, screws or plates into the bone fragments to keep everything nicely aligned. If you do get surgery on your broken toe, it is vital that you follow your surgeon’s post-surgery instructions. Not to get all horror-movie on you, but failing to do so may result in extremely serious complications.

Whatever you do, be sure to treat your toes well. If you do, they’re more likely to treat you well in return.