Does a patient with a nondisplaced fracture of the fifth toe (little toe) require consultation with an orthopedic surgeon?

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Last updated: May 14, 2025View editorial policy

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From the Guidelines

For a nondisplaced fracture of the little toe, you typically do not need to see an orthopedic surgeon. This type of minor fracture can usually be managed by your primary care physician or at an urgent care facility, as simple immobilization is often sufficient for small, nonarticular, or minimally displaced fractures, as noted in the American College of Foot and Ankle Surgeons' guidelines 1. Treatment generally involves the "buddy taping" method, where you tape the injured toe to the adjacent toe for support and stability, using gauze between the toes to prevent skin irritation.

  • Key aspects of care include:
    • Wearing wide, comfortable shoes with a rigid sole to minimize movement and protect the toe while it heals
    • Managing pain with over-the-counter medications like acetaminophen or ibuprofen as directed on the packaging
    • Applying ice for 15-20 minutes several times daily for the first 48 hours to reduce swelling
  • Most little toe fractures heal within 4-6 weeks. However, it's crucial to seek specialized care from an orthopedic surgeon if you experience:
    • Severe pain
    • Significant swelling or bruising
    • An open wound
    • Numbness
    • Or if the toe appears deformed or misaligned, as these may indicate a more complex fracture requiring professional intervention.

From the Research

Nondisplaced Fracture of the Little Toe

  • A nondisplaced fracture of the little toe is a common lower extremity fracture that can be caused by a crushing injury or axial force, such as stubbing a toe 2.
  • Most patients with a nondisplaced fracture of the little toe can be treated with buddy taping and a rigid-sole shoe to limit joint movement, without the need for referral to an orthopedic surgeon 2, 3.

Referral to an Orthopedic Surgeon

  • Referral to an orthopedic surgeon is indicated in patients with:
    • Circulatory compromise
    • Open fractures
    • Significant soft tissue injury
    • Fracture-dislocations
    • Displaced intra-articular fractures
    • Fractures of the first toe that are unstable or involve more than 25 percent of the joint surface 2
  • However, stable, nondisplaced toe fractures, including those of the little toe, do not typically require referral to an orthopedic surgeon 2, 3.

Treatment of Nondisplaced Fractures

  • Nondisplaced fractures of the little toe can be treated with buddy taping and a rigid-sole shoe for four to six weeks 3.
  • The treatment of nondisplaced fractures of the little toe is focused on limiting joint movement and allowing the fracture to heal, rather than requiring surgical intervention 2, 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Evaluation and management of toe fractures.

American family physician, 2003

Research

Diagnosis and Management of Common Foot Fractures.

American family physician, 2016

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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