What is the treatment for a toe fracture?

From the Guidelines

Treatment for a toe fracture should prioritize conservative management with immobilization, as surgery is usually reserved for cases with significant displacement or articular involvement. According to the American College of Foot and Ankle Surgeons, as reported in the American Family Physician journal 1, the diagnosis of a toe fracture is based on a history of trauma, focal pain on palpation, and confirmation with radiographic studies.

Key Considerations

• The treatment approach depends on the severity and characteristics of the fracture, with simple immobilization being appropriate for small, nonarticular, or minimally displaced fracture fragments.
• For most cases, especially those that are mild and non-displaced, conservative management is the preferred initial approach, aiming to reduce pain and promote healing.
• Pain management can be achieved with over-the-counter medications, and protective measures such as buddy taping or wearing supportive shoes can aid in the healing process.
• It's crucial to monitor the fracture's healing progress and seek medical attention if there are signs of complications or if symptoms do not improve as expected.

Management Strategies

• Conservative management: This includes rest, ice, compression, and elevation (RICE protocol), along with immobilization techniques like buddy taping for stability.
• Medical intervention: For more severe cases, proper alignment and possibly surgical fixation may be necessary to ensure proper healing and prevent long-term complications.
• Rehabilitation: Gradually returning to normal activities as pain subsides, and wearing protective footwear to prevent further injury. Given the potential for long-term complications if not properly managed, prioritizing conservative management while being mindful of the need for surgical intervention in more complex cases is essential, as indicated by the principles outlined in the study 1.

From the Research

Treatment for Toe Fracture

The treatment for a toe fracture can vary depending on the severity and location of the fracture.

• Stable, nondisplaced toe fractures can be treated with buddy taping and a rigid-sole shoe to limit joint movement 2.
• 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.
• Most toe fractures can be managed nonsurgically with a hard-soled shoe for two to six weeks 3.
• Lesser toe fractures can be treated with buddy taping and a rigid-sole shoe for four to six weeks 4.

Considerations for Treatment

When treating toe fractures, it's essential to consider the potential complications of buddy taping, such as skin injuries and limited joint motion 5.

• Low compliance and skin injury should be considered when using buddy taping to treat finger and toe injuries 5.
• The choice of pain medication is also crucial, with acetaminophen being a suitable option for pain relief after operative treatment of an extremity fracture 6.

Management of Specific Fractures

• Great toe fractures are treated with a short leg walking boot or cast with toe plate for two to three weeks, then a rigid-sole shoe for an additional three to four weeks 4.
• Metatarsal shaft fractures are initially treated with a posterior splint and avoidance of weight-bearing activities; subsequent treatment consists of a short leg walking cast or boot for four to six weeks 4.