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Toe Fractures | Metatarsal Fractures | Broken Toe | Broken Foot

Fractures of the toe and metatarsal bones of the foot are quite common, and are a very common sports injury. If you have a fracture, it means that the bone is broken - anything from a small crack to a bone that has changed its position and broken through the skin.

toe fractures broken toeFractures are placed into one of two categories: Stress fractures and Traumatic fractures.

A stress fracture, sometimes called a hairline fracture, is an injury caused by overuse - muscles become fatigued, are unable to absorb extra shock or weight, and eventually transfer the overload to the bone, causing a tiny crack. Stress fractures typically occur when the amount or intensity of an activity (like running) is increased too quickly. They're also common in sports when a player switches from a soft surface to a hard surface; in sedentary individuals who suddenly start exercising intensively; and in the elderly whose bones have been weakened by osteoporosis.

Stress fractures at first may be barely noticeable, but they will worsen over time without proper treatment. A stress fracture which isn't allowed to heal properly may lead to a traumatic fracture.

Symptoms of stress fractures include

  • Swelling
  • Pain
  • Tenderness in a specific area
  • Increased pain and swelling with activity
  • Pain begins earlier with each workout

Treatment for stress fractures

Your podiatrist at PA Foot and Ankle Associates may recommend one or more of these treatments to manage your stress fracture:

  • Rest (bone healing is delayed or prevented by continuing to put weight on it)
  • Ice if the area is bruised or swollen
  • Immobilization and protection with a walking boot, air cast, or crutches
  • Physical therapy after the bone is healed to increase muscle strength
  • Surgery with screws or pins if fracture is severe

How to avoid a stress fracture

  • Add intensity and distance incrementally to your workout - a good rule of thumb is no more than 10% each week. Adding weight and stress to a bone slowly allows it to build tolerance to the stress
  • Cross-training, like alternating bike riding with running, can help to prevent stress fractures
  • Strengthening exercises in the feet and legs keep muscles from becoming fatigued quickly and are more able to withstand strain
  • Wear properly fitting and padded athletic shoes to absorb shock
  • Exercise on soft surfaces like grass, dirt, or clay whenever possible
  • Eat correctly - nutrition plays a key role in bone development, and bones are always building and repairing. Make sure to include calcium and vitamin D-rich foods in your diet

A Traumatic Fracture, also called an acute fracture or break, is caused by a direct blow or impact, or by a sudden twisting movement. Traumatic fractures are considered either stable, with no shift in bone alignment; or displaced, where the bone has visibly moved its position.

Symptoms of a traumatic fracture may include

Your podiatrist at PA Foot and Ankle Associates may recommend one or more of these treatments to manage your traumatic fracture:

  • A "cracking" sound at the time of the injury
  • Pain at the site of impact which may increase with movement or use
  • Skin at area of injury may be pale
  • Crooked or abnormal appearance of the toe
  • Bruising and swelling
  • If severe, numbness or tingling sensations below the fractured area

Treatment of traumatic fractures in toes or metatarsals may include

  • Rest
  • Ice to reduce swelling
  • Pain medications
  • Splinting
  • Fracture reduction to realign bone in proper position (metatarsals only)
  • Immobilization with "Buddy taping" fractured toe to adjacent toe, or if metatarsals, short-leg walking cast, brace, or rigid shoe
  • In severe cases, surgery with screw or pin

Consequences of improper healing of a stress fracture or traumatic fracture

  • The old adage "if you can walk on it, it isn't broken", is far from the truth. Always have a fracture evaluated by a podiatric surgeon
  • A fracture which doesn't heal correctly can lead to arthritis, making the fractured area painful even after healing
  • A deformity in the bony architecture which may limit the ability to move the foot
  • Chronic pain and deformity
  • Injury of the fractured area a second time

A stress fracture or traumatic fracture of the toes or foot should always be examined and treated by a podiatric surgeon, even if you were first treated in an emergency room. A podiatric surgeon, specifically trained in the complexities of the foot and ankle, is the most appropriate physician to develop a treatment plan for your fracture.