Do fractures of the fifth toe (baby toe) require a boot cast?

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Last updated: May 5, 2025View editorial policy

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From the Guidelines

Most baby toe fractures do not require a boot cast. These small toe fractures typically heal well with conservative treatment including rest, ice, elevation, and over-the-counter pain medications like acetaminophen or ibuprofen (400-600mg every 6 hours as needed for pain) 1. You can "buddy tape" the injured toe to the adjacent toe using medical tape with gauze between the toes to prevent skin irritation, which provides stability while healing occurs. Wear wide, comfortable shoes that don't put pressure on the toe for 4-6 weeks. However, if the fracture is severely displaced (bone fragments are significantly out of alignment), open (bone has broken through skin), or involves multiple bones, medical evaluation is necessary and a walking boot might be recommended. Some key points to consider when treating baby toe fractures include:

  • The diagnosis is based on a history of trauma and focal pain on palpation and is confirmed with radiographic studies 1
  • Simple immobilization is appropriate when fracture fragments are small, nonarticular; or minimally displaced 1
  • Most baby toe fractures heal within 4-6 weeks
  • The baby toe bears minimal weight and has limited functional importance compared to other toes, and the surrounding tissues provide adequate support for proper healing in most cases.

From the Research

Fractures of Baby Toe Treatment

  • The provided studies do not directly address the treatment of fractures of the baby toe, specifically whether a boot cast is required.
  • The studies primarily focus on the use of antibiotic prophylaxis in open fractures, including the type and duration of antibiotic treatment 2, 3, 4, 5, 6.
  • There is no mention of the treatment of closed fractures, such as those that may occur in the baby toe, or the use of boot casts in these studies.
  • Therefore, there is no evidence to support or refute the use of a boot cast for fractures of the baby toe based on the provided studies.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Antibiotics and open fractures of the lower extremity: less is more.

European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2019

Research

Antibiotic Prophylaxis in Open Fractures: Evidence, Evolving Issues, and Recommendations.

The Journal of the American Academy of Orthopaedic Surgeons, 2020

Research

Update in Therapeutics: Prophylactic Antibiotics in Open Fractures.

Journal of trauma nursing : the official journal of the Society of Trauma Nurses, 2018

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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