Any toe can be fractured. Toes can break when people drop a heavy object on them or when people stub their toe.
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—see Symptoms).
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.
Doctors can often diagnose a toe fracture based on a physical examination. Usually, x-rays are not needed. If the big toe is fractured or if a toe is badly bent out of place (displaced) or rotated, x-rays are taken.
Usually, the only treatment needed 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.
Shoes should be comfortable and 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, specially designed shoes or boots with open toes, Velcro fasteners, and a rigid sole can be worn.