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Toe Fractures

By

Danielle Campagne

, MD, University of San Francisco - Fresno

Last full review/revision Jul 2019| Content last modified Jul 2019
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Any toe can be fractured.

  • The fractured toe is usually painful, swollen, and tender, and the nail may be discolored.

  • Doctors can often diagnose a toe fracture based on a physical examination.

  • Treatment usually consists of taping the fractured toe to the toe next to it (called buddy taping), but if the toe appears abnormally bent, the broken pieces of bone must be put back in place (reduced).

(See also Overview of Fractures.)

Toes can break when people drop a heavy object on them or when people stub their toe.

Symptoms

The fractured toe is usually painful, swollen, and tender. Often, blood collects under the toenail, especially if the toe was crushed, forming a purple-black spot (subungual hematoma).

Fractures of the big toe (hallux) tend to be more severe than those of other toes. The pain is more intense, and there is more swelling and bruising. People may be unable to walk.

Diagnosis

  • A doctor's evaluation

  • Sometimes x-rays

Doctors can often diagnose a toe fracture based on a physical examination. Usually, x-rays are not needed because treatment is the same whether the toe is fractured or not.

If the big toe is fractured or if a toe is badly bent out of place (displaced) or rotated, x-rays are taken from several different angles.

Did You Know...

  • For most toe fractures, no x-rays are needed.

Treatment

  • Buddy taping

  • For certain injuries, realignment of the broken bones

  • Comfortable shoes or specially designed shoes or boots

Usually, the only treatment needed for a toe fracture is taping the fractured toe to the toe next to it (called buddy taping) for several weeks.

If a toe is abnormally bent out of place, it may need to be realigned (reduced).

If blood has collected under the toe nail, doctors can release the blood and relieve the pain by making a small hole in the nail with a needle or a hot wire (electrocautery device). Usually, this procedure (called trephination) takes only a few seconds, and no pain relievers are not needed.

If the big toe is fractured, people should not put weight on the injured foot and should wear a shoe specially designed for people who have had foot surgery. These shoes have open toes, Velcro fasteners, and a rigid sole. Follow-up appointments with an orthopedic surgeon should be scheduled.

If a toe other than the big toe is fractured, people should wear comfortable shoes that protect the fractured toe. Wide, soft shoes place less pressure on the swollen toe, and rigid-soled shoes support the fracture. If walking in regular shoes is too painful, people can wear the shoes or boots specially designed for people who have had foot surgery.

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