Feet > Broken Toe

What is a Broken Toe?

Your toes consist of bones called phalanges. Your big toe is made of two phalanges: the distal at the tip of the toe, and the proximal at the base. Your other four toes have a middle phalange between the distal and proximal. Any of the bones in your toes can be fractured. The bone can be damaged in four ways:

   Compressed fracture – Forces press the ends of the bone towards the center.

   Comminuted fracture – The bone cracks into multiple fragments.

   Displaced fracture – The bone dislocates and moves out of its normal position.

   Non-displaced fracture - The bone is broken but remains in its normal position.

The most commonly broken toe is your little toe. When you break your toe, the fracture often occurs close to the toe’s joint with the longer midfoot bones (metatarsals), called the metatarsophalangeal joint. Broken toes may occur in conjunction with a toe dislocation, which knocks your toe out of its joint with the foot. Toe fractures and dislocations have similar symptoms and receive similar treatment.

Your toes consist of bones called phalanges. Your big toe is made of two phalanges: the distal at the tip of the toe, and the proximal at the base. Your other four toes have a middle phalange between the distal and proximal. Any of the bones in your toes can be fractured. The bone can be damaged in four ways:

   Compressed fracture – Forces press the ends of the bone towards the center.

   Comminuted fracture – The bone cracks into multiple fragments.

   Displaced fracture – The bone dislocates and moves out of its normal position.

   Non-displaced fracture - The bone is broken but remains in its normal position.

The most commonly broken toe is your little toe. When you break your toe, the fracture often occurs close to the toe’s joint with the longer midfoot bones (metatarsals), called the metatarsophalangeal joint. Broken toes may occur in conjunction with a toe dislocation, which knocks your toe out of its joint with the foot. Toe fractures and dislocations have similar symptoms and receive similar treatment.av=PAT&doc_id=29" target="_new">William G. Hamilton, M.D., team physician for the New York Knicks and New Jersey Nets.

Causes [top]

Direct contact commonly causes a broken toe. This can be from a heavy object falling on your toe, stubbing your toe into a corner when walking, or from someone stepping on your toe during sports. Sports that require you to wear cleats, such as soccer and football, put you at risk for breaking your toes. When your toe is bent or forced too far in any direction - up, down, or sideways - your bones can break or dislocate.av=PAT&doc_id=29" target="_new">William G. Hamilton, M.D., team physician for the New York Knicks and New Jersey Nets.

Considerations

Though many people may claim that there is not much you can do for a broken toe, if you do not seek medical treatment, you may have pain and a limp for an extended period of time. Your toe also can become permanently deformed if it heals in an awkward position. The majority of broken toes can be put back in position without surgery using a procedure called closed reduction. Your physician typically tapes the broken toe to the toe next to it to hold the toe in position while it heals. In rare cases, when your toe fracture is unstable - meaning your toe will not maintain proper position in its joint with your foot - your physician may need to make an open incision and fixate your toe with wires. This procedue is called internal fixation. The links to the left describe broken toe treatments in detail.

Orthopedic Evaluation  

There usually are three parts to an orthopedic evaluation: medical history, a physical examination, and tests that your doctor may order.

MEDICAL HISTORY [top]

Your physician likely will ask about your activities, which may have led to your breaking your toe. You will be asked when the pain began and to describe your pain’s duration and severity. If you have previously broken your toe, your physician will ask about treatments you have tried in the past. Physicians suspect a broken toe when you describe direct contact to your toe followed by pain and limited motion. Physicians also typically ask about other conditions, such as diabetes and allergies, and medications currently being taken. You may also be asked about your physical and athletic goals – information that will help your physician decide what treatment might be best for you in achieving those goals.

PHYSICAL EXAM

Physicians can often diagnose broken toes by putting direct pressure on your toes joint with your foot. Your toe usually is tender when pressure is applied. In a typical diagnosis, your foot is held steady and your toes are moved in different directions. If you have broken your toe, this test may cause significant pain, and your physician may notice limited motion in the injured toe compared to the healthy side. Your physician also may squeeze the tips of your toes to check for what is called "filling time." When your toes are squeezed, they lose color and slowly return to their normal color as blood returns and "fills" the toes. Your physician may do this to see how long it takes for the blood to return to your toe. By comparing a toe on the healthy foot to your injured toe, your physician can determine if you have problems with blood circulation.

TESTS

When your toe is visibly deformed, your physician may not need to perform further tests to make the diagnosis. However, X-rays usually are taken so you and your physician can see the extent of the broken bone tissue. X-rays typically are sufficient to show any fracture or dislocation in your toes.av=PAT&doc_id=29" target="_new">William G. Hamilton, M.D., team physician for the New York Knicks and New Jersey Nets.


Treatments
Closed Reduction, Immobilization
Open Reduction, Internal Fixation
 

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