From the Guidelines
For a proximal phalanx fracture of the pinky toe, conservative treatment with simple immobilization is usually the most appropriate approach, as surgery is typically reserved for more complex cases with significant displacement or articular involvement 1. When managing this type of fracture, it's essential to consider the principles outlined by the American College of Foot and Ankle Surgeons, which emphasize the importance of immobilization for small, nonarticular, or minimally displaced fractures 1.
- The R.I.C.E. protocol (rest, ice, compression, and elevation) can be applied for 3-4 weeks to promote healing and reduce pain.
- Buddy-taping the injured toe to the adjacent fourth toe using medical tape with gauze between the toes can provide adequate immobilization and support.
- Pain management can be achieved with acetaminophen (Tylenol) 500-1000mg every 6 hours or ibuprofen (Advil, Motrin) 400-600mg every 6-8 hours as needed, without exceeding maximum daily doses.
- It's crucial to wear wide, comfortable shoes that don't put pressure on the toe and allow weight-bearing as tolerated, gradually increasing activity as pain subsides.
- Medical attention is necessary if severe pain, numbness, color changes in the toe, or deformity occurs, as these may indicate a more complex fracture requiring alternative management 1.
From the Research
Proximal Phalanx Fracture of Pinky Toe
- A proximal phalanx fracture of the pinky toe can be treated conservatively with buddy taping and immediate mobilisation, as shown in a study published in the Danish medical journal 2.
- The study found that buddy taping allowed for immediate mobilisation and resulted in high overall satisfaction, with only four patients reporting mild pain at rest or work.
- Another study published in Hand (New York, N.Y.) found that stable fractures can be successfully treated nonoperatively, whereas unstable injuries benefit from surgery 3.
- A systematic review of nonsurgical treatments for Salter-Harris II proximal/middle phalanx fractures found that buddy taping can be an effective treatment option, with all fractures healing with no reported complications 4.
- A randomized controlled trial published in The Journal of hand surgery, European volume found that buddy taping is non-inferior to splinting after reduction of displaced extra-articular phalangeal finger fractures in children, with higher patient comfort in the taping group 5.
- However, a study published in Clinics in orthopedic surgery found that buddy taping can be associated with complications such as skin injuries and limited joint motion, and that low compliance and skin injury should be considered when using buddy taping to treat finger and toe injuries 6.