Fracture of the bones of the toe: symptoms, signs, treatment, recovery

Publication date: September 18, 2020

A broken big toe is a fairly common injury that a person can get while playing sports, at work, while walking, and even at home. Pain sensations differ from the severity of the injury and its size. For example, if we are talking about a fracture of only one nail phalanx, then it is quite easy to miss it or even confuse it with a regular bruise. And it is precisely because of the latter that a slight fracture can lead to quite serious consequences and improper healing. We strongly recommend that after a strong blow or injury, you can contact a medical center to rule out a fracture or begin its immediate treatment.

Signs of a broken toe

Depending on the location and severity of the fracture, symptoms can vary greatly. When a phalanx is cracked, pain is practically not felt, and the victim may not even be aware of the problem; very often the bone heals without plaster or fixation. When the first phalanx of a finger is fractured, severe, aching pain is felt.

When a toe is broken, the general symptoms are as follows:

• a hematoma forms at the fracture site;
• possible hemorrhage;
• the skin becomes dark blue, the skin around the damaged bone swells;
• severe and sharp pain with any attempt to touch or move a finger;
• unnatural mobility of the injured finger;
• inability to lean on the affected leg;
• immobility or partially limited movement of the finger;
• increased temperature and redness at the site;
• with a comminuted fracture, shortening of the finger is possible;
• with an open fracture, a wound with bone fragments;
• pronounced twitching or pulsating of the finger.

Upon physical examination, crunching of bone fragments is observed if little time has passed since the injury. The crunch is the result of the friction of broken bones against each other. Finger fractures are combined with damage to the ligamentous apparatus, sprains and dislocations of the phalangeal joints.

Foot structure

The human foot consists of 26 bones and includes three sections:

• Phalanges of fingers (14 bones).
• Each finger consists of three phalanges, only the thumb has 2 wide tubular bones.
• All toe bones are connected to the rest of the foot by the joints of the proximal phalanges.
• On the little finger, the upper two phalanges can often be fused, but this does not affect movement in any way.
• Tarsus (7 bones that form the heel and the connection to the shin).

The department includes the following bones:

• cuboid;
• wedge-shaped;
• scaphoid;
• talus (high bone);
• calcaneus (large bone).

Calcaneus

takes on the entire load, maintains balance, distributes weight. The bone is attached by many ligaments and tendons and has 6 joints. The talus connects the lower leg and foot, has 5 articulations, without muscles. This bone allows a person to turn the leg up to 90 degrees, raise it and lower it.

Scaphoid

is located next to the talus and forms the upward instep of the foot. The joint is formed by 3 sphenoid and cuboid bones, connected by tendons to the scaphoid.

Some people experience slight deviations in the structure of their feet. For example: another navicular bone, which causes shoe rubbing due to high arches. Or an additional bone behind the talus, which puts an end to ballroom dancing or ballet classes, due to the impossibility of standing on your toes.

Metatarsus

consists of 5 tubular bones that make up the middle part of the foot and form its arch. The first metatarsal bone is thickened, the second bone is longer than all the others. The entire department is responsible for finger movement.

The metatarsal bones are shaped like a pyramid, their front parts are rounded. The rounded heads of the bones are connected by joints to the phalanges, and at the base - to the tarsal bones.

The proximal parts of the bones are connected to fragments of the hindfoot.

The cause of the development of hallux valgus is a dysfunction of the first metatarsus. Valgus occurs due to salt deposits on the head of the first phalanx.

The coordinated functioning of the entire ankle is ensured not only by tendons, ligaments and joints, but also by muscles, nerve endings, and blood vessels.

The muscles are responsible for the extension and flexion of the fingers, except for the big one, and are located in the rear of the metatarsus. There are other muscles on the sole of the foot that are responsible for adduction and abduction of the toes and flexion of the foot.

How can you distinguish a possible bruise from a fracture?

A bruise or fracture can be determined by several parameters:

• Features of the pain syndrome.
• Finger movement.
• Skin color at the site of swelling (bruise).
• Presence of hemorrhage.
• Phalanx shape.

The clinical picture of a bruised finger is as follows:

• The victim experiences sharp pain, which begins to subside over time. The nature of the pain is “aching.” Using a cold compress can speed up the process of relieving pain symptoms.
• When bruised, the finger is not deformed. Immediately after a bruise, all movements are accompanied by sharp pain (pulsation is possible); as the pain subsides, the motor activity of the finger is gradually restored.
• Depending on the nature of the bruise, the color of the skin at the site of the injury may be dark red, pink, or pale pink. Swelling may appear immediately, after a day, or not appear at all. The blood at the site of the injury spreads diffusely (scattered), a bruise may appear.

Diagnostics

Deformation of the phalanx is easy to detect during external examination of the foot. Other types of cracks and fractures cannot be detected without the help of technical means. The patient must see a traumatologist or surgeon, who will determine the exact type of injury and its statute of limitations.

To clarify the type of finger fracture, the victim will need to have a fluoroscopy of the foot in two projections. After receiving reliable examination results, the doctor will determine the type of fracture and prescribe treatment.

How to diagnose a broken finger

• Upon palpation, the pain sharply intensifies and does not go away for a long time (an hour or two).
• When a fracture occurs, a sharp pain is felt, which can radiate to the nearest parts of the foot. Deformation of the phalanx, unnatural position of the finger. Swelling and strong (acute) pulsation at the fracture site.
• If there is a fracture, the victim cannot move the injured finger. Any attempt to stand on the affected leg causes the patient to experience severe pain. To relieve pain symptoms, the affected finger is fixed in one position.
• Hemorrhages form under the nail, hematoma and swelling appear, and the skin becomes bluish.

Ligamentous apparatus

The entire joint system provides the necessary functionality of the foot.

• Tarometatarsal - Small, flat joints with limited mobility. They form the base of the foot, with the help of ligaments in the tarsus.
• Interphalangeal - Provides immobility of the phalangeal bones.
• Subtalar - Inactive, located in the hindfoot, providing the arch of the talus and calcaneus.
• Metatarsophalangeal - A ball-and-socket joint that allows the fingers to flex and extend.
• Talocaleonavicular - Connects three bones to the axis of rotation. The foot can be rotated outward and inward.
• Ankle - A large joint connecting three bones. Forms a block between the tibia and the talus. The joint is attached to cartilage and forms ligaments on the side.
• All rotational and flexion movements of the leg occur at the expense of the ankle. The entire load while walking or running falls on the ankle joint.

The foot performs 3 functions:

• Supportive
  - the ability to prevent pressure from the supporting surface. If the function is impaired, the person experiences severe pain when running or jumping. When walking, the foot performs a pushing function - accelerating movement.
• Cushioning
  - smoothes out shocks when walking and running. It protects joints from damage. If the arch of the foot is low, then the function is reduced, diseases of the bones, joints, and sometimes internal organs develop.
• Balancing
  – provides full coverage of the support surface and maintains the position of the human body when moving.

First aid for a broken finger

If you have symptoms indicating a possible fracture, there is no need to panic in the first place. The first thing you should do is call an emergency ambulance. Before the doctor arrives, all efforts of the victim should be aimed at stopping the bleeding (in the case of an open fracture), fixing the limb and anesthetizing the injury site. To prevent negative consequences, the following rules must be followed:

• even in the absence of pronounced symptoms, one should not refuse to consult a doctor;
• fixation of the limb is one of the main stages of effective treatment;
• the broken finger should not touch foreign objects;
• non-displaced fractures may not be fixed until the ambulance arrives;
• pain can be relieved with nimesil, analgin and ibuprofen;
• A cold compress is another effective way to relieve pain.

It is important to note that when applying an ice pack, keep the compress for no more than 10 minutes to prevent possible frostbite. A repeat procedure is possible after a 3-4 minute break. Even if you suspect a fracture, experts recommend immediately contacting a specialized medical institution for qualified help.

Drug therapy

Three types of medications are used in the treatment of fractures:

• anti-inflammatory;
• painkillers;
• chondroprotective.

They are taken orally and topically on the painful area.

The action of the drugs provides:

• stimulation of the processes of restoration of damaged tissues;
• improvement of salt metabolism in bones (calcium-phosphorus);
• replenishment of calcium deficiency;
• elimination of inflammation.

The patient is prescribed: Chondroitin, Teraflex, Calcemin, Vitamin D3, Calcium Gluconate, Nise, Nurofen, Dexalgin. For local impact on the inflamed area: Traumeel-gel, Nise-gel, Voltaren.

The gel is applied three times a day.

Treatment methods for a broken finger

Classification

Types of toe bone fractures:

By localization:

• I, II, III, IV, V fingers;
• main, middle, nail phalanges;
• damage to the diaphysis, marginal fracture, epiphysiolysis.

By the presence or absence of a wound:

• open (with violation of the integrity of the skin);
• closed (without such violation).

Based on the presence of offset:

• with offset;
• without displacement.

Along the fracture line:

• transverse;
• oblique;
• longitudinal;
• helical;
• splintered.

Recovery

The rehabilitation period lasts up to two months. For the entire period, the patient must observe restrictions on exercise and movement, avoid long walks and sports.

Recommendations during the recovery period:

• exclude from the diet foods that wash calcium out of the body (coffee, carbonated and alcoholic drinks);
• eat foods rich in calcium (fish, cottage cheese, eggs, vegetables);

Visit a physiotherapy office:

• UHF lamps - to accelerate regenerative processes and metabolism - up to 15 sessions;
• Soda and salt baths - to eliminate callus after casting - up to 15 procedures;
• Applications with ozokerite or hot salt - to improve blood circulation;
• Therapeutic gymnastics for all fingers except the broken one - to prevent contracture - up to 20 sessions;
• Mechanical therapy (after casting) - to restore motility of the phalanges - 30 minutes a day, 25 sessions.

Causes

There are many situations in which a person can suffer a foot injury. Such injuries occur in domestic conditions or as part of the production process.

Often the cause of fractures is unsuccessful falls, careless sports, and violation of safety rules at the enterprise.

Provoking factors for finger injuries include the following:

• An intense blow or a fall on the leg from a heavy object;
• Sports injury that caused forced hyperextension of the foot;
• Sloppy movements;
• Hitting your foot on a hard object.

Features of rehabilitation

It is necessary to develop the foot after removing the cast under the supervision of a specialist. Typically, doctors recommend special exercises, therapeutic massage and physical therapy methods.

Full recovery from such an injury may take several weeks or 1 month. This period is spent on rehabilitation if there are no complications.

Immediately after removing the cast, you need to start doing therapeutic exercises. One of the most effective movements is to finger small objects with your toes. This exercise helps with nerve damage.

It is important to ensure that you do not put too much stress during training. Initially, classes should last 15-20 minutes. However, over time, their duration can increase to 1 hour.

Application of plaster casts

In traumatology, plaster or polymer bandages are used to immobilize the injured finger. The main advantage of polymer dressings is considered to be sufficient strength. In addition, they do not deteriorate when exposed to water, so wearing dressings made of polymer materials allows the patient to carry out all regular hygiene procedures. Another advantage of a polymer dressing is the absence of a cooling effect, which is experienced when using plaster.

Important! The disadvantage of this material is its high cost.

Polymer dressings

Applying a cast only to a broken toe will not produce results, because the ability to move the foot remains, which means that the toe is also not limited in movement. Only a sock-shaped bandage makes it possible to immobilize the toes along with the entire foot. Without this, proper healing of fractures is impossible.

In rare cases, a cast is applied

The use of fixing plaster or polymer dressings is not always required. Sometimes their use is impossible, in other cases it is not necessary.

1. Cracks on the phalanges of the fingers - they heal without additional actions.
2. The presence of fresh wounds after surgery on broken toes - plaster or polymer bandages are applied only after they have healed.
3. Use of the Ilizarov apparatus - this device provides fixation of fragments.

For cracks on the phalanges of the fingers, fixing bandages are not required