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Broken Toe

Dr. Matthew Garoufalis

Reviewed by
Dr. Matthew Garoufalis

Toes are the most commonly broken bones. Our toes are each made up of several small bones. Breaking or fracturing one of these bones can be painful and immobilizing. Most broken toes need four to six weeks to heal properly. Depending on the severity of the fracture or break, you may be immobilized for even longer, especially if surgery or a cast is needed.

Sometimes it is hard to tell whether you have broken your toe. Most broken toes occur after jamming the toe or when something falls onto the toe. Symptoms include swelling, pain, and discoloration. If the symptoms have not gone away within two or three days after the injury, or if you are unable to wear your normal footwear, you should seek medical attention.

Broken Toe Symptoms

If you break your toe you may begin to experience such symptoms as:

  • Pain
  • Swelling
  • Tenderness
  • Paleness or deformity of the toe
  • Weakness
  • Bleeding or immediate bruising
  • Inability to bear weight on the toe
  • Numbness, tingling or paralysis below the fracture (rare occurrence, especially in the toe, and requires immediate attention)
broken toes

Diagnosing a Broken Toe

Your doctor will probably start the appointment with questions about how you broke your toe, what symptoms you are having, and the activities you participate in. He or she will examine the toe and check for injuries to the nail or skin. X-rays may be used to determine the extent of the fracture. If additional injuries to the surrounding tissues are suspected, your doctor may order an MRI (magnetic resonance imaging) or CT (computed axial tomography) scan. Once the severity of the break has been determined, your doctor will be able to create an appropriate treatment plan for you.

What Causes a Broken Toe?

Most broken toes are the result of an injury. The injury can be sudden, such as when you stub your toe, or the injury can result from repetitive stress to the toes such as may occur during athletic activities that require starting and stopping quickly, sideways running, and jumping. This type of broken toe is called a stress fracture. A toe can also be broken if something heavy falls on it. This type of break is called an acute fracture.

Broken Toe Complications

If a toe breaks, complications can arise. For example, blood can begin to collect under the toenail, a condition called a subungual hematoma. Depending on the size of the hematoma, your doctor may need to drain the blood, which can result in pain and the loss of the toenail. After a broken toe heals, arthritis or osteoarthritis can develop, causing pain, stiffness, and deformities. Other times the bone fails to heal properly (malunion) or it will not heal completely (nonunion). If this happens, surgery may be the only option to treat the problem.

Broken Toe Treatment

There are several ways to treat a broken toe. Some methods can be performed at home, while others are performed by your foot doctor or podiatrist. At-home methods typically include RICE—Rest, Ice, Compression, and Elevation. This method is used for many types of leg and foot injuries. Your doctor may order to you to use crutches for one to three weeks, depending on the severity of the break or fracture. If the break is severe, the toe may need to be put back into place, either by splinting it or putting it in a cast. Occasionally, foot doctors recommend the use of a stiff-bottomed shoe to prevent the toe from bending. Other times they will use “buddy taping” for less severe fractures or breaks. Buddy taping involves taping the injured toe to a neighboring toe for additional support. If there are open wounds on or near the toe, you should expect to receive a tetanus shot and/or an antibiotic shot to prevent infections and additional problems.

If the broken bone pieces do not fit together properly, your doctor may need to perform a reduction to manipulate the pieces and fit them back together. In most cases, this procedure is not invasive, meaning no incisions or cuts need to be made in order to manipulate the bones.

Your doctor may suggest over-the-counter medications such as ibuprofen to relieve pain and swelling. Generally, your doctor will only prescribe pain killers if the break is severe, in which case surgery may be considered. Your podiatrist or foot surgeon will more than likely perform the surgery to realign the ends of the bones. Realignment is sometimes done using pins, plates, or screws to maintain proper positioning of your toes throughout the healing process. After surgery, a cast or splint is used to set the bone.

Children’s bones tend to heal more quickly, while elderly patients may never heal properly. The time required for healing depends on the type of the fracture and the extent of the tissue damage. In some cases, healing may take up to six months or more. In other cases, healing may only take six to eight weeks.

Preventing a Broken Toe

In some cases, a broken toe is unpreventable, but there are things you can do to reduce your chances of breaking your toe. Here are some preventative tips:

  • Wear shoes that protect your toes, especially for work and sports.
  • Wear shoes that fit properly.
  • Maintain a safe home to prevent falls. For example, slippery rugs, loose stair railings and slick floors increase your risk.
  • If you have a medical condition such as osteoarthritis, follow your treatment plan to avoid injury.
  • Take extra care when participating in high-impact activities.
  • Increase your Vitamin C and zinc intake to promote bone healing and strength.
  • Seek medical attention at the first sign of a fracture.

Questions to Ask Your Doctor

Here are some questions you may or may not want to ask your doctor about a broken toe:

  • What type of athletic shoe do you recommend based on my activities?
  • How long will it be before I can return to my normal activities?
  • If non-surgical treatment methods are not working, how long should I wait before contacting you again? What symptoms should I watch for?
  • How often should I shower while wearing a cast?
  • What is the process of washing my toe while it is healing?

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Medical References:

  1. M. Beers "Merck Manual of Medical Information" 2nd home edition (Pocket Books, 2003) 354
  2. H. Winter Griffith, MD "Complete Guide to Symptoms, Illness & Surgery" (The Berkeley Publishing Group, 2006) 183
  3. American Medical Association "Family Medical Guide" 4th Edition (John Wiley & Sons, Inc. 2004) 988
  4. American Academy of Orthopaedic Surgeons, Toe and Forefoot Fractures, http://orthoinfo.aaos.org/topic.cfm?topic=a00165

This page was last updated on December 17th, 2014



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