Toe & Metatarsal Fractures
Toe and Metatarsal Fractures (Broken Toes)
Broken toes and broken metatarsal bones can be painful, significant injuries. The structure of the foot is complex, consisting of bones, muscles, tendons and other soft tissues. Of the 28 bones in the foot, 19 are toe bones (phalanges) and metatarsal bones (the long bones in the midfoot). Fractures of the toe and metatarsal bones are common and require evaluation by a specialist. A foot and ankle surgeon should be seen for proper diagnosis and treatment, even if initial treatment has been received in an emergency room.
What are Toe and Metatarsal Fractures?
A fracture is a break in the bone. Fractures can be divided into two categories:
traumatic fractures and stress fractures.
Traumatic fractures (also called acute fractures) are caused by a direct blow or
impact, such as seriously stubbing your toe. Traumatic fractures can be displaced
or nondisplaced. If the fracture is displaced, the bone is broken in such a way that
it has changed in position (malposition).
Signs and symptoms of a traumatic fracture include:
• You may hear a sound at the time of the break.
• Pinpoint pain (pain at the place of impact) at the time the fracture occurs
and perhaps for a few hours later, but often the pain goes away after several hours.
• Crooked or abnormal appearance of the toe.
• Bruising and swelling the next day.
It is not true that “if you can walk on it, it’s not broken.” Evaluation by a foot and ankle surgeon is always recommended.
Stress fractures are tiny hairline breaks usually caused by repetitive stress. Stress fractures often afflict athletes who, for example, too rapidly increase their running mileage. They can also be caused by an abnormal foot structure, deformities or osteoporosis. Improper footwear may also lead to stress fractures. Stress fractures should not be ignored. They require proper medical attention to heal correctly.
Symptoms of stress fractures include:
• Pain with or after normal activity
• Pain that goes away when resting and then returns when standing or during activity
• Pinpoint pain (pain at the site of the fracture) when touched
• Swelling but no bruising
Consequences of Improper Broken Toe Treatment
Some people say that “the doctor can’t do anything for a broken bone in the foot.” This is usually not true. In fact, if a fractured toe or metatarsal bone is not treated correctly, serious complications may develop. For example:
• A deformity in the bony architecture, which may limit the ability to move the foot or cause difficulty in fitting shoes.
• Arthritis, which may be caused by a fracture in a joint (the juncture where two bones meet), or may be a result of angular deformities that develop when a displaced fracture is severe or has not been properly corrected.
• Chronic pain and deformity.
• Nonunion, or failure to heal, can lead to subsequent surgery or chronic pain.