Conditions - B

Definition

A broken toe is a common injury that most often occurs when you drop something on your foot or stub your toe.

In most cases, a broken toe can be immobilized by taping it to a neighboring toe. But if the fracture is severe — particularly if it involves your big toe — you may need a cast or even surgery to ensure that your broken toe heals properly.

Most broken toes heal well, usually within four to six weeks. Less commonly, depending on the precise location and severity of the injury, a broken toe may become infected or be more vulnerable to osteoarthritis in the future.

Symptoms

Signs and symptoms of a broken toe include:

• Pain
• Swelling
• Discoloration

When to see a doctor

Consult a doctor if the pain, swelling and discoloration continue for more than a few days or if the injury interferes with your ability to walk or wear shoes.

Causes

In most instances, a broken toe occurs when you drop something heavy on your foot or you stub your toe against something hard.

Complications

Complications may include:

• Infection. If the skin is broken near your injured toe, you are at higher risk of developing an infection in the bone.
• Osteoarthritis. This wear-and-tear type of arthritis is more likely to occur when the fracture extends into one of the toe joints.

Preparing for your appointment

While you may initially consult your family physician, he or she may refer you to a doctor who specializes in orthopedic surgery.

What you can do

You may want to write a list that includes:

• Detailed descriptions of your symptoms
• A concise explanation of how the injury occurred
• Information about other medical problems you've had
• All the medications and dietary supplements you take
• Questions you want to ask the doctor

What to expect from your doctor

Your doctor may ask some of the following questions:

• How did this injury occur?
• Were you barefoot at the time?
• Exactly where does it hurt?
• Is more than one toe involved?
• Do any particular foot motions make your injury feel better or worse?

Tests and diagnosis

During the physical exam, your doctor will check for points of tenderness in your toes. He or she will also check the skin around your injury to make sure it's intact and that the toe is still receiving adequate blood flow and nerve signals.

If your doctor suspects that you have a broken toe, he or she will probably order X-rays of your foot taken from a variety of angles.

Medications

The pain associated with simple toe fractures typically can be relieved with over-the-counter medications such as ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) or acetaminophen (Tylenol, others). Stronger painkillers can be prescribed if the pain from your fracture is more severe.

Reduction

If the broken fragments of your bone don't fit snugly together, your doctor may need to manipulate the pieces back into their proper positions — a process called reduction. In most cases, this can be accomplished without cutting open your skin. Ice or an injected anesthetic is used to numb your toe.

Immobilization

To heal, a broken bone must be immobilized so that its ends can knit back together. Examples include:

• Buddy taping. If you have a simple fracture in any of your smaller toes, your doctor may simply tape the injured toe to its neighboring toe. The uninjured toe acts like a splint. Always put some gauze or felt in between toes before taping them together to prevent skin irritation.
• Wearing a stiff-bottomed shoe. Your doctor might prescribe a post-surgical shoe that has a stiff bottom and a soft top that closes with strips of fabric fastener. This can prevent your toe from flexing and provide more room to accommodate the swelling.
• Casting. If the fragments of your broken toe won't stay snugly together, you may need a walking cast.

Surgery

In some cases, a surgeon may need to use pins, plates or screws to maintain proper position of your bones during healing.

Lifestyle and home remedies

Elevation and ice can help reduce swelling and pain. Prop your foot up when possible so that your injury is higher than your heart. If you use ice, wrap it in a towel so that it doesn't make direct contact with your skin, and only apply it for 20 minutes at a time.