The foot is a complex structure which consist of soft tissues, tendons, muscles and bones. The foot has 28 bones and 19 of them are toe bones. Toe bones may be very small, but they play an essential part in balance and walking. Having a broken toe can be extremely painful and inconvenient.

Toe fractures should be evaluated by a specialist doctor because if left untreated, the broken toe could progress to painful problems in future such as:

• Arthritis: This can develop in the affected joint if the joint is not correctly aligned before it heals.
• Long-term toe pain: If broken bones do not heal properly, they can cause ongoing pain or prevent healing. Same with walking on a broken toe too soon.
• Permanent deformity: A deformity can form if a broken toe is left untreated and this can cause problems with moving the toe and walking, as well as pain or discomfort when wearing shoes.
• Infection: A compound fracture which breaks the skin can develop infection if left untreated.

Causes of a Toe Fracture

A broken toe can occur when you stab your toe against a hard surface, or you drop something heavy on your foot.

Symptoms of a Toe Fracture

Symptoms of a broken toe normally differ from person to person. This is because for some people, they may carry on walking on the fractured toe while others may not due to the pain being unbearable. Factors affecting symptoms of a broken toe include:

• How the toe was broken
• The severity of the break
• If the broken toe has been displaced
• The point of breakage such as if near a joint
• If the patient has other medical conditions such as arthritis or gout

There are different types of toe fractures and each has its own symptoms. These include:

Traumatic fractures: These types of toe fractures are often as a result of a significant and painful event such as stubbing the toe very hard, falling or dropping a heavy object on the toe. Traumatic fractures range from minor to severe and as it happens you might hear a crack or a pop sound. Symptoms of a traumatic toe fracture include:

• Pain that does not go away with rest
• Bruising that is black, grey or dark purple in colour
• Throbbing
• Swelling
• Redness

Stress fractures: These types of fractures occur after repeated stress on the bone. They can occur months or even years after starting an activity that would put stress on the bones such as running. With time, the muscles in the toes can become too weak to absorb impact and this leads to the toe bone becoming vulnerable to pressure. Too much pressure on the toe bone can eventually cause it to crack.

Symptoms of stress fracture in the toe may include:

• Pain that goes away with rest
• Pain occurring after certain activities such as walking or running
• Tenderness or soreness when touched
• Swelling without bruising

Compound fractures: A displaced or compound fracture is the type that occurs when the bone is moved out of place. This usually occurs with severe traumatic fractures and it can cause the broken toe to appear crooked. This fracture may break the skin resulting in a protruding bone out of a wound.

Diagnosis of a Toe Fracture

Diagnosis of a broken toe involves a physical exam by your doctor to check for tender areas in your toes. The specialist will also check the skin around the injury to make sure that it is intact and that the nerve signals and blood supply are satisfactory.

An x-ray of the foot may be done and it will be taken from different angles to determine the severity of the fracture.

Treatment of a Toe Fracture

Treatment of a broken toe involves any or a combination of the following:

• Medication: These are given to manage the pain.
• Immobilization: A broken toe must be immobilized so that its ends can knit back together. Immobilization can include wearing a stiff-bottomed shoe, casting and buddy taping which is tapping the injured toe to its neighbouring toe. The uninjured neighbouring toe acts as a splint.
• Reduction: If the broken fragments of your toe fail to fit in securely together, they may need to be manipulated into their proper positions. This is known as reduction and it can be done without cutting your skin. Anesthesia will be needed to numb the toes prior to the procedure.
• Surgery: This may be done using plates, pins or screws so as to maintain the proper position of the bones during healing.

Next Step

At King’s College Hospital Dubai, we focus on offering an exemplary service, from initial consultation through to final diagnosis and treatment and beyond. Our multidisciplinary team of expert doctors, nurses, physio therapists are here to offer tailored management and treatment of your condition, and to answer any questions that you might have throughout your time with us. Whatever you need us for, we’re only a phone-call away.