From the Guidelines
Treatment for displaced toe fractures should prioritize reduction and immobilization to minimize morbidity, mortality, and improve quality of life. According to the American College of Foot and Ankle Surgeons, as reported in the American Family Physician journal 1, the diagnosis of toe fractures is based on a history of trauma and focal pain on palpation, confirmed with radiographic studies.
Key Considerations
- The goal of treatment is to achieve proper alignment and stability of the fracture fragments to promote healing and prevent complications.
- For minor displacements, closed reduction can be performed, while more severe displacements may require open reduction with internal fixation (ORIF) 1.
- After reduction, immobilization with buddy-taping and a rigid or post-operative shoe for 4-6 weeks is typically recommended.
- Pain management with acetaminophen or NSAIDs, ice application, and elevation can help reduce swelling and discomfort.
Treatment Approach
- The treatment approach should be individualized based on the severity of the fracture and the patient's overall health status.
- Follow-up x-rays are typically scheduled at 2-3 weeks to ensure proper healing, and physical therapy may be recommended after immobilization to restore strength and range of motion.
- Weight-bearing status depends on fracture severity, with partial weight-bearing with a walking boot allowed for less severe fractures, and non-weight-bearing with crutches initially for more severe cases.
- It is essential to prioritize proper treatment to prevent chronic pain, deformity, and arthritis, which can significantly impact the patient's quality of life 1.
From the Research
Displaced Toe Fractures Treatment
- Displaced fractures of the lesser toes should be treated with reduction and buddy taping 2
- Patients with displaced fractures of the first toe often require referral for stabilization of the reduction 2
- Buddy taping is a well-known method for treating toe injuries, but it can be associated with complications such as skin injuries and limited joint motion 3
- Operative treatment of toe fractures is only rarely necessary 4
- Lesser toe fractures can be treated with buddy taping and a rigid-sole shoe for four to six weeks 5
Treatment Considerations
- The treatment of displaced toe fractures depends on the location and severity of the fracture, as well as the patient's overall health and mobility 2, 5
- Referral to a specialist may be necessary for patients with complex or unstable fractures 2
- Buddy taping should be used with caution and careful monitoring to avoid complications 3
- A rigid-sole shoe can be used to limit joint movement and promote healing in patients with displaced toe fractures 2, 5