Losing a toe is a traumatic experience, and adjusting to the loss, physically and emotionally, is no picnic.
In this article we will explore some of the ways a toe may be lost or severed, and what effect this loss may have on your ability to walk, run, and participate in the same kinds of activities you did before the loss.
How Can Someone Lose Their Toe?
A toe can be lost in many ways—it can be severed in an accident (lawnmowers are a common cause of this type of mishap), or it may need to be amputated due to an infection following an improperly treated injury.
The number one reason for amputation of a toe, however, is diabetes. Because diabetes interferes with the body’s ability to fight infection, foot health is a matter of particular concern for diabetics.
Small injuries can become infected more easily, and in the infection is not treated promptly enough, the infection may become severe enough to require amputation of the toe, or even the entire foot.
This problem is exacerbated by other complications that may arise from diabetes, including diabetic neuropathy, which can interfere with an individual’s sensation of pain, causing them to ignore an injury until it has become severely infected, and poor circulation, which can lead to gangrene.
Complications Arising From the Loss of a Toe
Regardless of whether you had your toe severed in an accident or amputated in a hospital, life will be slightly different with your toe gone; how different depends largely on which toe you have lost.
The loss of the fifth toe (the little one) is generally of minimal consequence to one’s gait (i.e., manner of walking). While you may experience some unsteadiness at first, most people learn rather quickly to adapt to the loss of the fifth toe, and are thereafter able to walk normally, and even run.
The loss of the hallux—the big toe—is somewhat more serious, and may be more difficult to learn to compensate for.
The big toe is the last part of the foot to push off with every step we take, and while doing so it carries about 40 percent of the body’s weight.
Many people learn to walk—and even to run—following the loss of this toe, but it usually takes longer than recovery from the loss of the little toe, and may be more painful.
Also, because they are not designed to carry as much weight as the big toe, the other toes are not as strong, and may begin to hurt after you have been walking for a while.
Another problem with the loss of a toe, especially the hallux, is that over time, the bones of the foot may begin to shift positions.
Heather L. Lawver describes on her web site, Notoes.com, how this happened to her after her own big toe was amputated.
Her arch began to shift so that the inner edge of her foot curved inward, and her first metatarsal began to collapse onto the second metatarsal, pinching the major nerves running between the toes and causing intense, stabbing pain.
Finally, while stubbing your toe can be an extremely painful experience, stubbing a toe stump can be much more painful.
The bone of a toe stump may be much closer to the surface than the bone of an intact hallux, and it lacks both the cushioning and the flexibility of the toe, making unexpected impacts much more unpleasant. For this reason, most insurance companies are willing to cover the cost of a prosthetic toe.
Despite these concerns, with proper medical care the loss of a big toe need not result in significant disability in the long run, according to a study published in Clinical Orthopaedics and Related Research.
Emergency Treatment for a Severed Toe
If you or someone you know suffers an accident that results in a severed toe, it is important to remain calm.
If you are not the victim, do whatever you can to keep the afflicted person from panicking—an amputation injury is frightening, and viscerally upsetting as well.
Keep the foot raised, if possible, and try to apply direct pressure to the wound to minimize the bleeding. If enough of the toe remains to tie a tourniquet onto the stump, do so.
If the severed toe can be recovered, keep it away from dirt or other contaminants, and rinse it in clean water, if possible.
Wrap it in a clean, damp piece of cloth, put the cloth in a zip-lock plastic bag, and put the bag in ice-cold water.
Do NOT place the toe directly in ice water. Avoid putting the toe directly on ice—especially dry ice—as this may cause frostbite. Keep the toe as cool as possible without freezing it, and keep it away from heat.
A severed toe that is kept cool may be reattachable for as long as 18 hours after the accident; if not kept cold, it may only last as little as four hours.
Adjusting to the Loss of a Toe
Following the loss of a toe, there will be a period of emotional adjustment, which may be complicated by the pain of recovery. You may experience anxiety about walking again, and some people begin to fret over the change in the cosmetic appearance of their feet.
After the loss of a limb or digit, many people experience phantom pain—the sensation that the lost toe is still there, and it hurts! Phantom itching is also common. These sensations are unpleasant, but they will pass eventually. Ask your doctor what can be done about them.