Do Broken Toes Really Need Medical Attention?

toe fracture

One of the most common foot injuries is the toe fracture.  This seemingly minor injury can be the source of much pain and annoyance, and often hails from a midnight misadventure to the bathroom as a dresser suddenly lurches in the way of the unsuspecting sleepy victim.  The common assumption is that there is nothing that can be done for a toe fracture, so why bother to have it addressed?

My response to this is that if it were a finger, would one not seek medical attention?  Yes, I realize toes and fingers serve two very different purposes.  However, the anatomy of the injuries is generally the same, and the severity of not addressing these injuries in a timely manner could be equally problematic.

Toe fractures can run the gamut of simple clean breaks, all the way to displaced fractures that stick out away from the intact bone.  Clean breaks are simply treated with buddy splinting of the injured toe to the next toe, and the use of a stiff soled shoe.  However, there is no external indication as to whether a toe fracture is a clean break or if it is shifted out of position, and the level of pain or swelling associated with the injury does not offer a true clue either.  X-rays and medical attention are needed to determine this, as a decision has to be made as to what needs to be done to put the toe bone back into place and keep it there while it heals.  This may be as simple as manually distracting the toe to put the fracture in place with the use of splints to keep it there, or, in serious cases, treatment may require surgery to repair and secure the broken bone.  The danger of the bone not setting right comes in the form of future issues with the toe, which includes new areas of prominence from the displaced and malformed bone that may rub in shoes and cause sores (a particular danger for diabetics), long term pain from a non-healing fracture, or long term arthritis if one of the joint surfaces in the toe was disrupted by the separated fracture.

Ignoring a toe fracture could prove costly, as some non-healed fractures require additional surgery to remove the fractured bone end in an effort to end pain.  A simple visit to a physician, preferably a foot specialist (who by nature deals with toe fractures on a regular basis), can ensure that this nagging injury heals properly, quickly, and without long term consequence.

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How Much Should A Good Pair of Shoes Cost?

shoe shopping

I am often asked by my patients: “how much should I spend on a good pair of shoes to keep my feet from pain?”   The answer to this question is not as simple as one would expect.

The short answer to this question is that cost may not necessarily matter.   Shoe prices, while often reflective of the overall quality and construction of the shoe, are just as loosely dependent on the whims of the fashion world as any other article of clothing.  Certain trendy items and products from high end fashionable manufacturers will always have higher prices that do not necessarily reflect either the quality or the medical grade ‘worth’ of the actual shoe.  In fact, some highly expensive shoes are downright awful for the human foot.

Recent poor trends include rocker bottom shoes a few years ago, and more recently lightweight minimalist type of cushioned shoe.  Of course, the fashion industry historically always contributes its own horrific shoe designs that have little correlation with the actual shape of the foot.

rocker bottom fitness shoesalexander-mcqueen-armadillo-2

Given these considerations, the most expensive shoe is not necessarily the best.  So how can one gauge how much should be spent on a shoe?   Well, the way to ultimately reach this decision is to forget about price.  First and foremost, a shoe should be proper for one’s foot structure.  In particular, flatter feet need stiffer shoes, high arch feet need cushioned shoes, and regular feet need something in between.  Your podiatrist can help determine what type of shoe your foot structure requires.  From this basic criteria, one must then figure out what type of activity the shoes are going to be worn in, as this influences the general need for construction quality and durability. Finally, one should be properly fitted into the shoes by a trained clerk who knows their products well.  Often, this does require going to a store that costs a little more in exchange for better service.

From the above criteria, the price of the shoe should become self apparent based what shoe supports one’s foot the best, is appropriate for its intended activity (daily use versus labor versus specific athletic activities etc.), and fits appropriately.  The price of the shoe that fits these criteria is the price you should pay.

Oh, if you are paying over $180 on a pair of retail shoes, you really are paying too much, no matter what you are buying.