Last week I had three patients with fractured toes who all said the same thing. "I didn't think there was anything to do for a fractured toe."
I am wondering why so many people think that there is nothing you can do for such a common problem. It is true that you really can't put a cast on a toe, but a fracture of any of the twenty eight toe bones is no different than a fracture of any other bone. The toes should be treated with the same respect as your other bones!
A fracture is a broken bone. Any fractured bone requires several conditions to heal. First of all, the bone fragments must be in proper position to heal. An X-ray will determine if a fracture is displaced (the fragments are left in an abnormal position) or non-displaced. Even a non-displaced fracture needs stability to allow the pieces of bone to adhere together and fuse. If a fracture doesn't heal, it can cause long term pain similar to arthritis. Injured bone, like any tissue, also needs proper circulation to heal. The blood vessels will be able to work more effectively and reach the damaged tissue better once the bone fragments are stabilized. Ensuring a bone fracture to heal is no different than ensuring a bone surgery to heal. The bone (or bones) needs to be stabilized and immobilized.
Immobilization is achieved by stopping the mobilization or movement of a body part. A properly applied cast will stop both the bones and muscles from their normal action and is often used in an ankle or foot injury. A cast can be used for a fracture of the long bones of the foot, but not for the toes.
However, immobilization of the toes can be accomplished. Proper tapping techniques and the use of a surgical shoe will prevent motion of the toe. A surgical shoe works so well, it is often used in place of a cast for bunion surgery. This special shoe limits any motion at the fracture or site of surgery. The combination of tapping and a surgical shoe will not only stabilize the bone and allow the swelling to go down, but will also dramatically reduce the pain that is felt. My last patient's husband was so surprised to hear how much better her toe felt once it was properly taped and immobilized!
All three patients with toe fractures waited several weeks to be evaluated hoping the problem would resolve on its own. I don't have a problem with waiting a few days to be sure that the injury is more than a simple bruise, but it is important to see a podiatric physician sooner, rather than later, for a possible fracture. Digital X-rays allow the x-ray images to be magnified and allow for a much more accurate diagnosis of toe fractures. If the fracture is displaced, it will be difficult (if not impossible) to put them back in place without surgery if treatment is delayed. Waiting several weeks also delays the healing several weeks and results in a much longer recovery time without returning to normal activities.