Toe and Forefoot Fractures
Toe fractures are common and most occur in the smaller toes. Metatarsal fractures are the most common foot fracture after toe fractures. Metatarsals are the long bones in the mid foot.
Toe and metatarsal fractures are painful, range in severity, and can make walking difficult, but are seldom disabling. Many of these fractures can heal without surgery. Importantly, it is not true that if you can walk on it, it isn’t broken.
Toe Fractures
Most toe fractures are caused by trauma such as a fall, stubbing the toe, or dropping a heavy object on the toe. When the fracture is aligned it can be treated with conservative measures. Toe fractures tend to heal slowly, and the toe can stay swollen for long time. After the fracture heals, there may be complications including arthritis, pain and stiffness, and deformity. A stress fracture of a toe can result from prolonged repeated movements that stress the bone. It takes about 6 weeks for a broken toe to heal.
Symptoms of a traumatic toe fracture
- pinpoint pain at the location of the impact which may resolve after a few hours
- crooked toes
- swelling and bruising
- difficulty walking
Before seeing an orthopedic surgeon, stay off the foot, elevate the foot, apply ice, take an OTC pain reliever, and wear stiff soled shoes.
Treatment for traumatic toe fractures
- Rest
- splinting
- rigid or stiff soled shoe
- buddy taping- wrapping the toe with the adjacent toe.
- surgery – in rare cases a severe toe fracture may need surgery, and a cast or splint.
Metatarsal fractures
The metatarsal bones are the long bones between the toes and the ankles. Metatarsal fractures can be caused by trauma or repetitive stress. Traumatic metatarsal fractures are common in children. Treatment options depend on the type and extent of the fracture. Stress fractures of the metatarsals are common in athletes, especially runners and dancers.
Metatarsal stress fractures
Stress fractures are hairline cracks caused by repetitive stress. Metatarsal stress fractures are common, caused by a sudden increase in physical activity, improper conditioning or training, and a change in the training surface from inside to cement. The risk is also related to foot shape, tight calf muscles, a tight Achilles tendon, or metabolic and nutritional factors like osteoporosis.
Symptoms of a stress fracture:
- pain during or after normal activity
- pain that resolves with rest and returns with activity
- pinpoint pain when touched
- swelling but no bruising.
Traumatic metatarsal fractures
Traumatic fractures of the metatarsals are caused by sudden force like a fall, twisting or crush injury, or dropping heavy object on foot. Risk factors include athletes, obese individuals, and people with osteoporosis, rheumatoid arthritis or diabetes.
The fracture may be stable with the bones aligned or displaced and out of alignment. Ballet dancers commonly fracture the 5th metatarsal on the outside of the baby toe. Metatarsal fractures are also found in tennis where the ankle twist and tears the tendon off the bone and take a piece of bone with it. A Jones Fracture is the most common break near the base of the 5th metatarsal that interrupts blood supply and can take longer to heal or require surgery. A fracture of the first metatarsal bone behind the big toe can lead to arthritis. This is called Hallux rigidus. Metatarsal fractures vary in severity according to age and the cause of injury.
Symptoms are painful swelling and difficulty bearing weight or walking.
Diagnosis of toe and metatarsal fractures
Your OANC orthopedic surgeon will discuss the circumstances surrounding the injury, ask about your symptoms, and conduct an examination to locate the injury. X-rays and bone scans are used to diagnose the fracture.
