What is Toe Fracture

Toe fracture is a break in one of the toe bones (phalanges).

What are the causes?

This condition may be caused by:

What increases the risk?

This condition is more likely to develop in people who:

What are the signs or symptoms?

The main symptoms of this condition are swelling and pain in the toe. The pain may get worse with standing or walking. Other symptoms include:

How is this diagnosed?

This condition is diagnosed with a physical exam. You may also have X-rays.

How is this treated?

Treatment for this condition depends on the type of fracture and its severity. Treatment may involve:

You may need follow-up X-rays to make sure that the bone is healing well and staying in position.

Follow these instructions at home:

If you have a cast:

• Do not stick anything inside the cast to scratch your skin. Doing that increases your risk of infection.
• Check the skin around the cast every day. Report any concerns to your health care provider. You may put lotion on dry skin around the edges of the cast. Do not apply lotion to the skin underneath the cast.
• Do not put pressure on any part of the cast until it is fully hardened. This may take several hours.
• Keep the cast clean and dry.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths for bathing.
• If your health care provider approves bathing and showering, cover the cast or bandage (dressing) with a watertight plastic bag to protect it from water. Do not let the cast or dressing get wet.

Managing pain, stiffness, and swelling

• If you do not have a cast, apply ice to the injured area, if directed.
• Move your toes often to avoid stiffness and to lessen swelling.
• Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.

Driving

• Do not drive or operate heavy machinery while taking pain medicine.
• Do not drive while wearing a cast on a foot that you use for driving.

Activity

• Return to your normal activities as directed by your health care provider. Ask your health care provider what activities are safe for you.
• Perform exercises daily as directed by your health care provider or physical therapist.

Safety

• Do not use the injured limb to support your body weight until your health care provider says that you can. Use crutches or other assistive devices as directed by your health care provider.

General instructions

• If your toe was treated with buddy taping, follow your health care provider’s instructions for changing the gauze and tape. Change it more often:
• Wear a protective shoe as directed by your health care provider. If you were not given a protective shoe, wear sturdy, supportive shoes. Your shoes should not pinch your toes and should not fit tightly against your toes.
• Do not use any tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. Tobacco can delay bone healing. If you need help quitting, ask your health care provider.
• Take medicines only as directed by your health care provider.
• Keep all follow-up visits as directed by your health care provider. This is important.

Contact a health care provider if:

• You have a fever.
• Your pain medicine is not helping.
• Your toe is cold.
• Your toe is numb.
• You still have pain after one week of rest and treatment.
• You still have pain after your health care provider has said that you can start walking again.
• You have pain, tingling, or numbness in your foot that is not going away.

Get help right away if:

• You have severe pain.
• You have redness or inflammation in your toe that is getting worse.
• You have pain or numbness in your toe that is getting worse.
• Your toe turns blue.

Toe Fracture Rehabilitation

Ask your consulting doctor which exercises are safe for you. Do exercises exactly as told by your doctor and adjust them as directed. It is normal to feel mild stretching, pulling, tightness, or discomfort as you do these exercises, but you should stop right away if you feel sudden pain or your pain gets worse. Do not begin these exercises until told by your health care provider.

Stretching and range of motion exercises

These exercises warm up your muscles and joints and improve the movement and flexibility of your foot. These exercises also help to relieve pain, numbness, and tingling.

Exercise A: Plantar flexion with toe extension, seated

1. Sit on a chair that lets your feet rest flat on the floor.
2. Keeping your toes firmly on the ground, lift your left / right heel off the ground. You should feel a stretch under your toes.
3. Hold this position for __________ seconds.
4. Bring your heel back down to the floor.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise B: Ankle alphabet

1. Sit with your left / right leg supported at the lower leg.
   1. Do not rest your foot on anything.
   1. Make sure your foot has room to move freely.
2. Think of your left / right foot as a paintbrush, and move your foot to trace each letter of the alphabet in the air. Keep your hip and knee still while you trace. Make the letters as large as you can without increasing any discomfort.
3. Trace every letter from A to Z.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise C: Assisted toe flexion

1. Sit with your left / right leg crossed over your opposite knee.
2. Hold your left / right ankle with your hand from the same side of your body. With your other hand, hold your toes.
3. Use the hand that is holding your toes to gently curl your toes down toward the bottom of your foot. You should feel a stretch on the top of your toes and foot.
4. Hold this position for __________ seconds.

Repeat __________ times. Complete this exercise __________ times a day.

Strengthening exercise

This exercise builds strength and endurance in your foot. Endurance is the ability to use your muscles for a long time, even after they get tired.

Exercise D: Towel curls

1. Sit in a chair on a non-carpeted surface, and put your feet on the floor.
2. Place a towel in front of your feet. If told by your health care provider, add __________ to the end of the towel.
3. Keeping your heel on the floor, put your left / right foot on the towel.
4. Pull the towel toward you by grabbing the towel with your left / right toes and curling them under. Keep your heel on the floor while you do this.
5. Let your toes relax.
6. Grab the towel again. Keep going until the towel is completely underneath your foot.

Repeat __________ times. Complete this exercise __________ times a day.

Balance exercise

This exercise will help improve the control of your toe and foot when you are standing or walking.

Exercise E: Single leg stand

1. Without shoes, stand near a railing or in a doorway. You may hold onto the railing or door frame as needed for balance.
2. Stand on your left / right foot. Keep your big toe down on the floor and try to keep your arch lifted.
3. Hold this position for __________ seconds.
4. If this exercise is too easy, you can try doing it with your eyes closed or while standing on a pillow.

Repeat __________ times. Complete this exercise __________ times a day.