A broken toe (toe fracture) is usually the result of direct external violence. Symptoms include a swollen, bluish toe that does not move properly. He can be treated conservatively with a tape bandage or a special plaster shoe – surgery is rarely. Read how to recognize that a toe is broken and what the treatment looks like.
Broken toe (toe fracture): description
A broken toe is one of the most common forefoot fractures. Every year, about 140 out of 100,000 people suffer a toe fracture. Here are slightly more men than women affected.
A toe fracture affects one or more toes. Most toes are composed of three bones: basic limb, middle limb and end limb. The big toe is an exception because it consists of only two bones. In some people, the middle toe and end limb of the little toe are fused together. Most often, the base of the little toe is broken.
Broken Toe: Symptoms
If a toe is deformed, hurts, and has limited mobility, the toe is broken. Symptoms such as swelling and bruising (under the nail or all over the toe) may be added. In addition, the nail bed is often injured in a toe fracture. A broken little toe is often recognizable by its clear malposition.
Broken Toe: Causes and Risk Factors
As a rule, a broken toe is caused by a direct, external act of violence. If a small toe is broken, it is usually the well-known “bedpost injury”. In doing so, the little toe sticks to the bedpost or the table or chair leg when passing by.
If a heavy object falls on the toes, often several toes are broken (including with rubble zones). A high-energy trauma may also be the cause – such as in a motorcycle accident, in which not infrequently, the entire forefoot is affected with significant soft tissue damage.
Broken Toe: Examinations and Diagnosis
If you suspect a toe break, you should consult a doctor for orthopedics and trauma surgery. To determine if the toe is broken or sprained, the doctor will ask you first about the accident and your medical history. Some questions from the doctor might be:
- How did the accident end?
- Did you hit your foot or did an object fall on your foot?
- Do you have pain?
- Did you already have complaints such as pain and restricted movement in the foot area?
After that, the doctor will examine your toe. An open fracture is easy to recognize: bone fragments are visible through an open skin area. A closed toe break occurs when the broken toe is dislocated, abnormally agile, or you hear a bone drift. Sometimes a bruise on the toe occurs. However, small fractures often lack secure fracture signs, so ultimately only one radiograph will provide a clear diagnosis. The x-rays of the forefoot are made from two different directions and diagonally from the side.
Broken Toe: Treatment
Usually a broken toe heals without much difficulty. Only inadequate treatment can delay healing in some cases.
Broken toe (toe fracture): Conservative treatment
If the toe break is slightly or not shifted, it is treated conservatively. The doctor will tap the broken toe: He puts on a plaster bandage – with a roof tile-like plaster bandage fixed the broken toe with a neighboring healthy toe (buddy taping).
In children, a broken toe only has to be taped for three weeks. Adults should wear the dressing for four to five weeks until the pain subsides. If the malposition still remains, an operation must be considered.
A broken toe should only be loaded with pain. If several toes are injured, the patient is put on a plaster shoe (geisha shoe). The foot can not be unrolled and thus fully loaded.
Broken Toe (Toe fracture): Surgical treatment
An unstable broken toe is operated on. A broken big toe is fixed with screws or plates. If the fracture forms a step in the metatarsophalangeal joint, it must also be surgically corrected so that the foot can be unrolled without pain. Fractures of the remaining toes are fixed with mini screws or wires.
If there is an open toe break, the damaged tissue is removed and the entire wound area rinsed extensively. A possible foot compartment syndrome should be relieved as soon as possible. In compartment syndrome, tissue pressure increases due to swelling and blood, which squeezes and eventually destroys nerves, muscles, and vessels within a fascia.
Broken toe (toe fracture) with nail bed injury
Often, the nail bed is also injured in a toe break. It must then be treated, as otherwise the nail can splinter and it can lead to a deformation of the nail and chronic infection. A displaced nail must be removed and, if necessary, sewn or either splinted with the original nail or a synthetic nail.
If you have a painful bruise under the toenail, make two small holes in the nail to help drain the blood more easily. The nail bed must not be injured.
Broken Toe: Disease Course and Prognosis
An operation on the toes carries the risk of complications – either through the procedure itself or the fixation material used. As with any surgery, wound healing disorders, infections and inadequate bone healing are included.
Broken Toe: Healing Duration
In most cases, a broken toe can be treated well. It takes about five to six weeks for the bone to heal. The toe can then be fully loaded again and has no more pain. Patients suffering from sensory disorders of the foot due to diabetes are becoming broken toe often noticed late – a late visit to the doctor and thus treatment can delay healing.