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Last updated: July 14, 2025View editorial policy

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Differential Diagnosis for Big Toe Fracture

Single Most Likely Diagnosis

  • Traumatic fracture of the distal phalanx: This is the most common type of big toe fracture, often resulting from a direct blow to the toe, such as dropping something on it or stubbing it.

Other Likely Diagnoses

  • Sesamoid fracture: The sesamoid bones are two small bones embedded within the tendons under the big toe. Fractures here can occur due to repetitive stress or acute trauma.
  • Turf toe: An injury to the ligaments around the big toe joint, typically occurring when the toe is forcibly bent upward, common in athletes.
  • Stress fracture of the proximal phalanx or metatarsal: Overuse injuries that can occur in runners or dancers due to repetitive stress on the bones of the foot.

Do Not Miss Diagnoses

  • Compartment syndrome: A condition where increased pressure within a muscle compartment can lead to muscle and nerve damage. Though less common, it's a medical emergency that requires prompt treatment.
  • Open fracture: A fracture where the bone pierces the skin, leading to a high risk of infection. Immediate recognition and treatment are crucial.
  • Neurovascular injury: Damage to the nerves or blood vessels surrounding the fracture, which could lead to serious complications if not addressed promptly.

Rare Diagnoses

  • Avascular necrosis of the sesamoid bones: A condition where the blood supply to the sesamoid bones is disrupted, leading to bone death. This is rare but can occur after a fracture.
  • Infection (osteomyelitis or septic arthritis): Though more common in open fractures or in people with certain health conditions, infection is a rare but serious complication of a closed big toe fracture.
  • Pathological fracture: A fracture that occurs in a bone that has been weakened by an underlying disease, such as osteoporosis, cancer, or a bone cyst.

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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