Toe fractures are common due to the force often applied to the small toe bones when one stubs their toes or drops a heavy object on them.  Sometimes this force can simply result in a bruising or strain of the toe tissue.  At other times the injury is strong enough to break the bone.

Fractures of the toe bones can take numerous shapes.  there are two bones in the big toe, and three in all the others.  A fracture can occur in any of those bones.  The fracture can run straight across the bone, at an angle, or can even break into several pieces during a crush-type injury.  The toe fracture may even only partially go across the width of the bone, resulting in a green-stick fracture.  Small chips may be present if only the end of the bone is involved, and the fracture can affect the function of a joint if the fracture crosses that joint.  Externally, the toe often becomes swollen, red, and, may have bruising.  It will be painful to the touch, or with shoe pressure.  Sometimes the  symptoms may be minimal and the toe may not ‘feel’ fractured.

Toe fractures often stay in place, with the bone fragment moving only slightly out of alignment.  Because of this, many toe fractures can heal on their own with the support of splinting to the next toe over.  Bones generally take six weeks to heal, and toe bones are no exception.  If there is extra motion of the toe that lets the bone fragments shift and move, the healing can take longer, or the bone will heal in an abnormal position.  This ultimately may result in new pressure points on the top or sides of the toe, which can lead to painful corns.  Abnormally healed fractures that involve a joint can also lead to future early arthritis.  Because of this, it is important that a fractured toe be properly assessed and treated.

Some fractures are more unstable and require further treatment, especially those of the big toe.  These fractures have pieces that need to be manipulated back into place with traction and then splinted until healed.  If the fracture cannot be returned into a proper position with this maneuver, or if the fracture is severely unstable, surgery may be necessary to put the bone into a proper position The bone is usually held with some form of metallic hardware to keep it stable until healing is completed.

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