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Toe Fractures

By Danielle Campagne, MD , Assistant Clinical Professor, Department of Emergency Medicine, University of San Francisco - Fresno

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Most toe fractures are minimally displaced and require only taping to an adjacent toe (buddy taping).

Pain, swelling, and tenderness are common. Subungual hematoma (between the nail plate and nail bed) is also common, particularly when the mechanism is a crush injury.


  • If certain injuries are suspected, x-rays

Unless rotational deformity or joint involvement is suspected or the proximal phalanx of the great toe is injured, x-rays are usually unnecessary because treatment is the same whether fracture is present or not. When x-rays are indicated, anteroposterior, lateral, and oblique views of each toe are taken.


  • Buddy taping

  • For certain injuries, reduction and fixation

Treatment involves taping the injured toe to an adjacent toe (dynamic splinting, or buddy taping). If the toe is displaced or deformed, reduction may be needed before buddy taping. Fixation is sometimes indicated (eg, for fractures with marked displacement or rotational deformity of the great toe).

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