Fractures of various bones, especially limbs, are quite common and ubiquitous. The leading place among them is occupied by toe fractures.
Various external damaging factors - twisted toe, bruise, compression - can cause a toe fracture. Such fractures are called traumatic. Along with them, pathological fractures are also distinguished that occur as a result of certain systemic diseases (osteoporosis, osteomyelitis, bone cancer, thyroid dysfunction and others) due to impaired bone tissue strength.
In accordance with the classification accepted in medicine, the following fractures of the toes are distinguished:
Symptoms of toe fractures can be either absolute or relative.
The absolute ones include:
Relative symptoms are:
The intensity of relative symptoms directly depends on the location of the fracture. To make an accurate diagnosis and verify the presence of a toe fracture, in addition to the available relative and absolute signs, the doctor will need to conduct a detailed interview with the patient and verify the actual objective changes on the x-ray.
First of all, the difference between the big toe and the rest is in the number of phalanges - there are two of them. Functionally, it bears the main load when walking. Fractures of the big toe are often intra-articular and are characterized by severe pain and loss of function. When the big toe is fractured, bluishness and swelling may spread to the entire surface of the foot and other toes.
The nature of the toe fracture influences the choice of treatment. In case of an open fracture, it is necessary to restore the normal position of the bone fragments and surrounding tissues (reposition), and immobilize the finger (immobilization). In this case, the introduction of an anti-rabies vaccine or serum and antibacterial therapy are also required.
If the localization of the injury is in the area of the nail phalanx, treatment of a toe fracture begins with pain relief. Then the blood clot is removed from under the nail plate, and the bone is immobilized and fixed.
Treatment of a toe fracture in the area of the middle and main phalanx most often requires the application of a plantar plaster splint for 1-1.5 months.
If the violation of the integrity of the bones of the toe is localized inside the joint, then surgical treatment will be required using wires, and in some cases, an Ilizarov apparatus. After completing the course of treatment, a repeat x-ray is also necessary. The stress on a previously broken finger should be limited.
As a pre-medical aid if you suspect a toe fracture, you need to elevate the leg to ensure blood flow and reduce tissue swelling at the site of injury, and also apply cold to the sore spot for 15 minutes. Similar measures are also recommended in the first few days after injury.
To prevent toe fractures, it is recommended to wear comfortable shoes with orthopedic insoles.
A toe fracture is a traumatic injury that occurs when the toe is twisted, compressed, or receives a strong blow to the toes. Such an injury can occur even while at home, after hitting a corner or furniture.
In addition, there are pathological fractures of the toes, which are the result of the negative effects of certain diseases that reduce the strength of bone tissue. Such diseases include osteomyelitis, osteoporosis, hyperparathyroidism and others. The most common foot injury is a fractured big toe.
A toe fracture can be closed or open, without displacement or with displacement, complete or incomplete. Depending on the location, the injury can be on the nail, middle, or main phalanx, or a combination.
With an open fracture, bone fragments tear muscles, ligaments and skin, which leads to communication of the wound with the external environment. Pathological fractures are open only in rare cases.
Due to the structure of the toes, the bone can be damaged in several places at the same time. It is the location of the injury that determines the symptoms of a fracture.
This type of injury has relative and absolute characteristics. Relative signs include intense and acute pain that intensifies when attempting to move, dysfunction of the limb, swelling of the injured finger, hemorrhage under the skin or nail. Among the absolute symptoms of a finger fracture are its pathological mobility, unnatural position, crepitus in the area of the injury, that is, when pressure is applied, a characteristic crunch of bone fragments is heard.
Relative features are always present to one degree or another. Their intensity depends on the location of the injury. For example, with a fracture of the distal phalanx of the toe, pain is less pronounced compared to damage to the main phalanx connecting to the bones of the foot.
When a fracture occurs, damage occurs to the vessels, the size of which varies at the base of the finger and near the nail, so the swelling and hematoma with a fracture of the main phalanx is much greater than with an injury to the distal edge of the finger.
A fracture of any finger other than the thumb may not even be immediately noticed by the victim. The injury is detected only when the pain syndrome increases.
A fracture of the big toe stands out somewhat among similar injuries and has more pronounced symptoms. This finger is larger and consists of two phalanges, rather than three like the others. In addition, while walking he experiences more stress than others. Therefore, its injury is characterized by sharp, intense pain, which prevents the victim from stepping on his foot. In this case, the swelling spreads to the foot and neighboring toes, the skin on the foot becomes bluish, and the foot swells.
To diagnose this injury, as with any fracture, an x-ray examination is necessary. Even in the presence of relative and absolute signs, an external examination does not guarantee an accurate diagnosis.
If injured, it is necessary to provide the victim with first aid. To relieve pain and increasing swelling, you need to apply cold to the injured finger, after which a splint is applied to immobilize the injured limb. Such measures will avoid further complications and partially relieve the victim’s pain. There are no major arteries in the toes, so an open fracture will not cause significant bleeding. After this, you should not take any independent measures; you should consult a traumatologist as soon as possible.
The treatment regimen depends on the nature of the damage. If this is an open fracture, then mandatory measures to reposition bone fragments and immobilize the limb are supplemented with antibiotic therapy to prevent the development of a secondary infection.
Simple fractures of all toes except the big toe can be treated without a plaster cast. It is enough that a splint is applied to the broken finger for a period of 4 to 7 weeks. To relieve pain, it is recommended to use orthopedic shoes or shoes with hard soles. A fracture of the big toe requires a plaster cast from the toes to the upper third of the leg for a period of 4 to 6 weeks.
Treatment of a toe fracture with intra-articular injuries often requires surgical intervention, which involves open reduction, intra-articular fixation using special pins and, in some cases, the application of compression-distraction devices. After this treatment, full functionality of the fingers is restored after 2 months.
To speed up the process of restoration and regeneration of bone tissue, as with any fractures, it is recommended to carry out restorative therapy, including physiotherapeutic procedures and a diet high in protein and calcium. It is also possible to use biologically active food additives that stimulate collagen synthesis.
This article is posted for educational purposes only and does not constitute scientific material or professional medical advice.
A fracture is a damage to bone tissue, resulting in its integrity being compromised. They differ in the nature of the injury and its location. The limbs are most susceptible to fractures due to their anatomical features and high mobility.
A broken toe is a fairly common injury. Such frequent damage is associated with its structure and assigned functions. The big toe, unlike other toes, has two phalanges, and when walking it bears the main load (see photo 1).
A fracture can theoretically be caused by two reasons:
However, often these reasons are closely interrelated. After all, there are cases of even a minor external impact (severe bruise) that leads to a fracture. They are:
You can distinguish a fracture from a bruise by the main signs that accompany it. Symptoms can be divided into indirect and direct (precisely excluding bruise), precisely indicating damage to the integrity of the bone.
Painful symptoms are quite tolerable. A sharp pain manifests itself at the very moment of the bruise, then it passes into the stage of dull pain. At this time, swelling occurs and the inflammatory process begins to develop. A clearer sign that indicates a fracture is a light tap on the top. This manipulation allows you to clearly distinguish a fracture from a bruise. In the first case, pain is felt precisely at the site of injury, but if there is no such manifestation, it means a bruise.
Direct symptoms that help determine a fracture are:
Palpation must be carried out quite carefully. The crepitus of the fragments is clearly audible. It should be noted that these manipulations should be performed when absolutely necessary. If possible, the symptoms of a bruise or fracture of the phalanx should be confirmed using an x-ray of the foot in two projections. This diagnosis allows you to accurately exclude a bruise and determine the location of the fracture, as well as the location of bone fragments. This will allow the doctor to identify the complexity of the injury and choose the optimal treatment.
After a finger injury, first aid must be provided. It is designed to significantly reduce pain and discomfort. To do this, pain relief is performed (taking pills and cold compresses), then, if the fracture is open, the wound is treated with an antiseptic solution and only then the fracture is fixed. Then you need to call an ambulance or take the victim to the hospital. Ambulance transport will have a more positive outcome. Firstly, medical workers who arrive at the call will provide first aid and fix the finger correctly, which will contribute to the speedy recovery of the phalanx of the finger.
When transporting, it is recommended to keep the injured leg in a heel-resting position, with the toes not in contact with anything that could cause pain and further impairment.
Ketanov, nimesil, paracetamol, aspirin, analgin, ibufen, etc. are taken as painkillers. The dosage for a fracture is doubled as prescribed in the instructions. There is no need to mix drugs or increase the dose yourself.
A fixation bandage should be applied only if there are signs indicating bone displacement; in other cases, additional disturbance of the finger causes even more pain. Immediately after an injury (whether it is a bruise or a fracture), you need to take a horizontal position and place a bolster or pillow under your foot.
Cold compresses are simply an irreplaceable remedy that quickly eliminates pain symptoms. You can do them for 5-10 minutes with a break of a couple of minutes to prevent frostbite of the tissue.
Treatment of a fracture is purely individual. In case of an open injury, the bone is restored and returned to its place. Afterwards, a cast is applied and a course of antibiotics is given to prevent infection. If the injury causes damage to the nail plate with accumulation of blood, then anesthesia is administered and the blood is removed, after which a cast is applied from the top of the shin to the finger, which must be worn for at least 1.5 months. In case of a fracture of the thumb joint, treatment is carried out through surgery. Sometimes, when restoring the integrity of a joint, it is necessary to do fixation using knitting needles or a compression-distraction device. With this type of injury, the fracture heals much more slowly. The cast will have to be worn for at least 2 months. All this time, while the bone is healing, treatment is carried out with vitamins C, D, B12, and it is recommended to take easily digestible calcium.
Plaster is the optimal form of immobilization for fractures. It is quite simply applied and firmly fixes the bone, but it has its negative sides. The cast is susceptible to getting wet, which causes the bandage to lose its shape. During the cold season, it quickly cools down and cools the leg, which harms the newly formed callus. When a toe is broken, a cast is applied to the entire foot and part of the lower leg. A plaster cast is not used for minimal bone cracks and the open wound is still healing during the first days after surgery.
Treatment with complete immobilization lasts until bone integrity is completely restored. How long this will take depends on the individual patient. On average, a fracture heals in 4-10 weeks.
The first place among the causes of broken toes can be attributed to blows, when a person accidentally hits something with his foot. Fractures caused by diseases that cause a decrease in bone strength: osteoporosis, osteomyelitis, thyroid dysfunction and others are much less common. Moreover, due to the fact that the big toe is larger than the rest and when walking it bears a greater load than the other toes, its fracture is most common.
Symptoms of toe fractures are usually divided into absolute and relative.
Relative symptoms include:
The symptoms described above are typical for a fracture of any toe, but in the case of a fracture of the big toe, the signs are much more pronounced. Sharp pain is observed all the time; the victim cannot step on his foot. Swelling develops quickly and spreads to adjacent toes or even to the entire foot. The leg may take on a bluish tint.
If for non-displaced fractures of other toes they are often simply fixed with an adhesive plaster or limited to applying a plaster splint (splint) to the foot, then for a fracture of the big toe, plaster is always applied. Moreover, the plaster covers the leg from the toes to the upper third of the leg, and is applied for 5-6 weeks. If the distal (nail) phalanx of the big toe is fractured, the nail may need to be perforated to remove accumulated blood.
In case of intra-articular fractures, it is sometimes necessary to resort to surgical intervention with fixation of bone fragments.
It should also be noted that you should seek medical help immediately if you suspect a fracture, since if swelling develops, applying a plaster may be difficult or impossible, which can subsequently lead to improper bone healing.
In addition, the doctor may prescribe vitamin supplements and calcium supplements to stimulate faster bone healing.
Complicated rehabilitation after a big toe fracture is not required. The main thing is to wait the right period and allow the fracture to heal, and not to put stress on it ahead of time. In addition, at first you may need to use special orthopedic insoles.
For a practicing traumatologist or surgeon, fractures are quite common. A fairly common injury is a fracture of the big toe, which occurs due to heavy objects falling on the foot, when it is twisted, or as a result of a strong blow.
Due to certain anatomical and functional differences between the first toe and other toes, treatment of a fracture and subsequent rehabilitation will have some characteristic features.
The first toe usually protrudes noticeably forward, experiencing the maximum load when walking. That is why he is most often injured.
The main cause of a broken big toe is excessive force. A high probability of such injuries occurs in childhood or the elderly. In the first case, the bones are very fragile due to the active growth phase, and in the second, they are prone to osteoporosis.
Most often, a fracture of the big toe occurs due to the following factors:
In the majority of cases, fractures of the first toe are the result of injuries. Much less often, the causes are pathological in nature, when the traumatic factor acts on a bone that was initially changed due to various pathologies. Examples include tumor processes, tuberculosis or osteomyelitis.
Fractures of the first toe are usually classified according to the severity of the damage and their nature. Depending on this, therapy is prescribed, the duration of the rehabilitation period and the final outcome are predicted.
In medicine, it is customary to distinguish the following types of fractures in the thumb area:
Due to the fact that the first toe has three phalanges, each of them can be susceptible to injury. A combined fracture is possible when two or all three phalanges on the finger are broken.
Since there are quite large vascular and nerve bundles located in the area of the big toe, they are always injured during a fracture. As a result, hematomas form and intense pain appears.
Important! The most important thing is that as a result of a fracture of the first toe, walking becomes almost impossible. A fracture of just one toe deprives a person of the ability to engage in daily activities and live a full life.
Symptoms of a big toe fracture can be absolute and relative. The former make it possible to more accurately determine a fracture of the first toe, while the latter only help to suspect it.
Absolute symptoms include:
Relative symptoms are:
The intensity of each of these symptoms may vary depending on the type, location, severity of the fracture and the presence of its complications. Symptoms will be more pronounced if the main phalanx of the finger, which directly connects to the base of the foot, is fractured.
An intra-articular fracture causes intense pain and hematomas, which often spread to the remaining fingers. To clarify the diagnosis, in addition to asking the patient about the causes of injury and complaints, additional research methods are of great importance.
For any type of fracture, X-ray examination is still considered the gold standard. This painless diagnostic method does not require special preparation and can highly reliably confirm or refute the presence of a fracture. With its help, the nature of the injury and the degree of displacement of bone fragments are established.
In complex diagnostic cases, computer or magnetic resonance imaging may be prescribed. Studies with great accuracy make it possible to identify fractures of varying degrees with the presence of intra-articular injuries or damage to surrounding soft tissues. The effectiveness of treatment directly depends on how accurately the diagnosis is made.
For fractures in the area of the big toe, there are several treatment tactics, each of which depends on the location of the injury and its nature:
A plaster cast is most often applied from the toes to the knee joint. Pain relief is relieved with the help of painkillers.
For intra-articular fractures, an operation is usually performed, which is necessary to fix the joint with special knitting needles. In this case, plaster is applied for a period of at least 6 weeks.
A cast on your leg is no fun for anyone, but it is strictly necessary in the treatment of fractures. When wearing a cast for a long time, joint mobility suffers, muscles begin to atrophy, and the nutrition of surrounding tissues deteriorates. Therefore, appropriate rehabilitation is necessary.
Rehabilitation measures for a fractured thumb:
All together they will contribute to the rapid healing of bone fragments and further restoration of the functioning of the big toe.
Massage and thermal physiotherapeutic procedures will increase blood flow and nutrition in the area of damage. A couple of procedures are enough to enhance the effect of the treatment.
It is best to massage on both legs. On the injured limb, the space around and under the plaster cast should be covered. It is useful to do self-massage using simple stroking and rubbing, especially with cedar oil.
Therapeutic exercise helps restore joint mobility and speed up the recovery process. Below is an example set of exercises:
At a later stage, you can scatter pencils or pens on the floor. They should be collected with your toes and placed in one place.
Important! All exercises must be done carefully and slowly. There is no need to rush or overload. If pain occurs, you must immediately stop and stop the exercise. You should just sit down and relax.
There is no need to immediately put a significant load on the leg. We need to increase it gradually. The most useful exercise will be simple walking. Regular walking short distances (around the apartment) will help restore mobility in a short time.
The need for timely treatment and compliance with rehabilitation rules is explained by the high probability of complications:
To avoid these problems, you should promptly contact medical institutions for help with any injuries to your big toe. There is no need to self-medicate, as this can only make the situation worse.
After the fracture heals and the leg regains its former mobility in the foot, there is no need to immediately start running or exercising on exercise equipment. Everything should be gradual, the load should be increased little by little. Proper nutrition should be maintained even after the end of the rehabilitation period as a preventive measure.
You should include a large amount of dairy and fermented milk products in your diet. Sea fish, legumes, fruits, vegetables and herbs will be useful. Sea kale, broccoli, egg yolk, liver, and butter will bring a lot of benefits. Daily sunbathing will promote the production of vitamin D and improve your mood. Giving up bad habits and a healthy lifestyle will help consolidate the results.
You don't need to put your heels on right away. This will cause excessive stress on the thumb and may result in its curvature or the formation of cartilage deposits. It is best to choose comfortable and spacious shoes.
It will be useful to regularly repeat some physical therapy exercises and undergo sanatorium-resort treatment. The simplest and most accessible remedy for absolutely everyone is to prevent a fracture of the big toe. To do this, it is enough to wear comfortable shoes and even wear slippers at home. Simple safety measures when carrying heavy objects, rollerblading, skiing or skating will help prevent fractures and avoid unnecessary consequences.