(See also Overview of Fractures Overview of Fractures A fracture is a break in a bone. Most fractures result from a single, significant force applied to normal bone. In addition to fractures, musculoskeletal injuries include Joint dislocations... read more .)
Toes fractures may result from dropping a heavy object on the toes or stubbing them.
Pain, swelling, and tenderness are common. Subungual hematoma Subungual hematoma and nail bed trauma Deformities are often considered together with dystrophies, but the two are slightly different; deformities are generally considered to be gross changes in nail shape, whereas dystrophies are... read more (between the nail plate and nail bed) is also common, particularly when the mechanism is a crush injury.
Unless rotational deformity or joint involvement is suspected or the proximal phalanx of the great toe (hallux) 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.
Treatment of a toe fracture 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).
If the great toe is fractured, patients should not put weight on the injured foot and should wear a hard-soled postoperative shoe; follow-up appointments should be scheduled with an orthopedic surgeon.
A fractured toe is usually painful and swollen; a subungual hematoma commonly forms, particularly when the toe has been crushed.
Take anteroposterior, lateral, and oblique views of each toe if rotational deformity or joint involvement is suspected or if the proximal phalanx of the great toe is injured; otherwise x-rays are usually unnecessary because treatment is the same whether fracture is present or not.
Tape the injured toe to an adjacent toe; if the toe is displaced or deformed, reduction may be needed first.
If the great toe is fractured, instruct patients not to put weight on the injured foot, treat with a hard-soled postoperative shoe, and make sure patients schedule follow-up appointments with an orthopedic surgeon.