Broken Toe and Metatarsal Fracture: symptoms & treatment options

What are the symptoms of a broken toe? 

Broken toes are common injuries that often present with pain and difficulty in walking. The severity of these symptoms can differ significantly among individuals. While some might be able to walk despite the fracture, others could experience overwhelming pain.

Several factors influence the symptoms of a broken toe, including:

• The extent of the fracture.
• Displacement of the broken bone from its normal position.
• The nature of the fracture.
• The specific location of the break, particularly if it's near a joint.
• Co-existing medical conditions, like gout or arthritis.

Given the broad spectrum of symptoms, which can range from mild to severe, it can be challenging for many to distinguish between a broken toe and other types of foot injuries, like muscle sprains or severe bruises.

While pain and difficulty walking may be common symptoms, the specific symptoms of each type of fracture have some variations.

Traumatic toe break symptoms 

Traumatic fractures, which are common among athletes, often result from painful and impactful incidents like falls, severe toe stubbing, or having a heavy object dropped on the toe.

The symptoms of a traumatic toe break begin immediately and include:

• Some patients report hearing a “crack” at the time of the break.
• Pain is generally localized at the place of impact.
• The fractured toe may appear to be crooked.
• Bruising or swelling can occur the day following the injury.
• The area under the toenail can bruise if something was dropped on the toe.

Symptoms for stress fractures of the toe 

A stress fracture is usually an overuse-type of injury that produces a small crack in the bone. It is due to either normal amounts of stress to a weakened bone, or abnormal amounts of stress to a normal bone.

Often, patients report having a sudden increase in the intensity of their physical activity or recently beginning a new workout regimen. This can put excess stress on a region of the foot or ankle, resulting in a small crack or stress fracture.

Symptoms of a stress fracture in the toe include:

• Pain that goes away with rest and is worsened with increased or repetitive activities.
• Localized swelling in the area of the fracture that becomes worse with activity.
• Slight burning feeling from the swelling and tenderness in the area.

Should I go to the doctor for a broken toe? 

While many toe breaks can be treated simply, complications can occur if they are not properly attended to. These include:

• Arthritis: Arthritis can develop if the bones are displaced due to the break and not properly realigned. This is especially true if the break involves a joint.
• Chronic pain: Improper healing of the fracture may lead to persistent pain in the toe.
• Failure to heal: Not only may the toe not get better, but the pain can continually worsen.
• Deformity: A break that heals without proper alignment can result in a permanent deformity of the toe.
• Decreased Mobility: A misaligned or improperly healed toe can affect your ability to walk normally or wear certain shoes comfortably.

What are the treatments for a broken toe? 

You can usually manage pain from a broken toe with over-the-counter medications such as ibuprofen (Motrin) or acetaminophen (Tylenol). Prescription pain medication may be prescribed for severe pain. Ice packs applied for up to 20 minutes at a time can help alleviate pain and swelling.

Additional treatment can vary depending on the location of the break.

Big toe fractures 

Fractures in the big toe are often treated in two stages. A walking boot or cast can be prescribed for the first two to three weeks following the break, and then a rigid shoe for weeks three and four of healing.

Small toe fractures 

Smaller toe fracture treatment includes splinting or “buddy taping,” which keeps the toe in the proper position by taping it to the adjacent toe. We put gauze between the taped-together toes to prevent the skin between the toes from developing sores or blisters. Additionally, a protective or stiff-soled shoe can help keep the toe properly aligned.

Metatarsal fractures 

Most metatarsal fractures will heal without surgery, using conservative methods. A walking cast/boot or protective footwear may be prescribed to keep the bones in a stable position while they heal. Taping or strapping may also be used for added stability and support.

In rare cases, the injured toe may be dislocated and need to be re-aligned before it can be splinted. In these cases, the toe is numbed and the bones are re-set. X-rays are taken to ensure proper realignment of the bone. Follow-up appointments are critical for our doctor to check that your toe is healing right.

In the case of a displaced fracture where there is a large gap between the bones, it may need to be surgically put back in place. Screws, pins, and/or plates hold the fracture together as they heal. Most displaced fractures treated with surgery involve a six- to eight-week recovery period in a walking cast or boot.

Open fractures 

If the fracture is open (the bone has broken through the skin), it is advisable to seek emergency care. In an open fracture, the bone and internal tissues are exposed to the external environment, significantly increasing the risk of bacterial infection.

Open fractures have a higher risk of developing complications like nonunion (failure to heal), malunion (healing in an incorrect position), and osteomyelitis (infection of the bone).

Jones Fracture: fracture of the fifth metatarsal 

It is important to note that there is an area of the fifth metatarsal, which is notorious for non-healing. This fracture, also called a "Jones Fracture," may require surgery due to the low blood supply to this particular area of the fifth metatarsal.

Why UFAI is your Best Choice for Foot and Ankle Care 

Using the most advanced techniques, some of which we helped develop, has allowed us to maintain the highest success rates in the nation for ankle injuries. Our goal is to quickly get you back on your feet, utilizing the least invasive treatments possible.

Patients are our number one priority. Beginning with the ease of making your appointment, our family-friendly office staff is with you every step of the way. We have our own X-ray, musculoskeletal ultrasound, and even an MRI and 3D CT at many of our facilities.

We also offer orthotic and brace manufacturing as well as on-site physical therapy services and state-of-the-art operating rooms. This means you will rarely have to go from one specialist to the next, cutting down on your travel needs and wasted time.

While most orthopedic surgeons focus on all the bones and joints in the body, only spending a fraction of their time on the foot and ankle, UFAI's surgeons choose to treat foot and ankle conditions as their lifework.

Podiatric foot and ankle surgeons concentrate exclusively on the foot and ankle from day one of medical school. After medical training, they begin a rigorous three-year surgical residency. What sets podiatric surgical residents apart from general orthopedic residents is they specialize in the foot and ankle while most (though not all) ortho residents do not.

Years of training and decades of experience and research are why the foot and ankle surgeons at UFAI have the highest success rates in the United States, literally helping thousands get back on their feet and back to their lives.

 

Broken Toe FAQs 

 

When can I go back to normal activities after breaking my toe?

The timeline for returning to normal activities after breaking your toe varies depending on the severity of the toe injury and your individual healing process. Generally, a broken toe can take about four to six weeks to heal sufficiently for most activities.

 

Every injury is unique, so it's crucial to get personalized advice from a healthcare provider. Returning to activities too soon can delay healing or lead to further injury.

 

How to sleep with a broken toe? 

Sleeping comfortably with a broken toe requires a few adjustments to minimize pain and aid healing. Here are some tips:

 

• Elevate your foot to reduce swelling.
• Consider using a special foot brace or boot to stabilize your toe.
• Try to sleep on your back as much as possible. This position prevents putting pressure on the injured toe.
• If your doctor has prescribed pain medication, take it as directed, especially before bedtime to help manage pain and discomfort.
• Apply a cold pack before going to bed to reduce swelling.
• Ensure your blankets and sheets are loose around your feet to prevent putting pressure on the broken toe.
• Try to limit moving around in bed too much to avoid accidentally hitting or putting pressure on the injured toe

 

Sources

Bica D, Sprouse RA, Armen J; Diagnosis and Management of Common Foot Fractures. Am Fam Physician. 2016 Feb 193(3):183-91.

Evaluation and Management of Toe Fractures | AAFP

https://www.aafp.org/afp/2003/1215/p2413.html