Toe and Metatarsal Fractures
Let’s have a little story, shall we? Gordon was stumbling around his
bedroom one night (with the light off, for fear he would wake his
slumbering wife) when his pinky toe caught on the corner of a dresser and
snapped. Gordon crumpled in pain, yelled like a soccer fan after a big win,
and woke up his wife anyway.
How about another story? Helen decided to run a marathon. She thought to
herself, “I jog several miles a day anyway, and how much harder could twenty be
than five?” The first day she started training, she pushed herself to ten miles
and barely made it home. The second day, she did twelve and nearly collapsed
from exhaustion. After a week of pushing herself hard, she went out again, only
to discover after about one mile that her foot hurt so much she couldn’t even walk back to her house. She called her neighbor to come and get her. Resting with her foot propped up seemed to help, so she tried running again the next day, only to be gobsmacked by the same pain.
And another? When she was hauling her twenty-third box to her beat-up
truck, Paula wished she had called her brothers to help her move into her
new dorm room. Unfortunately, she was all by herself when she lifted a box
of books, took a couple of steps, and lost her grip. The box plummeted down
to the ground and landed squarely on top of her big toe.
These stories may be somewhat…unhappy…but they do help to illustrate a few
ways you can break your toes or metatarsals. Basically, breaks in these
bones (they make up over half the bones of your foot, by the way) can
happen in a couple of different ways. You can have a traumatic fracture,
which is a break from a specific event, like dropping a box of books on
your foot or catching your toe on a piece of furniture, or a stress
fracture, which is when tiny cracks in your bones develop over time.
Sometimes stress fractures are a result of a change in your exercise
routine (like Helen’s story), or they can develop over long periods of
time, often due to structural abnormalities in the foot, a condition like
osteoporosis, or wearing improper shoes. (And we’re not talking ‘improper’
as in the shoe doesn’t covers your foot modestly. We’re talking about shoes
that don’t support your foot adequately, or cause additional stress to your
Bone breaks come in many different varieties. They can be open or closed
fractures (open fractures mean the bone has broken through the skin; with
closed fractures, your skin remains intact). Bones can also be displaced
(moved from their proper position), or stable (the bones are still in the
correct place). You may even have an avulsion fracture when something (like
a strained tendon) pulls a piece off the main part of the bone.
Some people may believe that doctors can’t do anything for broken toes, but
the truth is that there are treatments available. And some toe breaks may
even require surgery. Staying away from the podiatrist’s office when you
have an injury to your foot can lead to serious complications, like
deformities, arthritis, chronic pain, and failure of your bone to heal. So,
don’t just ignore your injured digit: see a podiatrist about it as soon as
Traumatic breaking of your bone might be pretty obvious to you. Sometimes
people feel or hear a crack when the break happens. Broken bones are also
pretty painful, although the pain tends to be pinpointed to the location of
the break. This pain may go away after a few hours, or subside somewhat.
You may also notice swelling in the injured area, as well as bruising, and
your toe or foot may appear crooked or abnormal.
Stress fractures may be a bit less obvious. They’ll be painful, but the
pain will likely subside with rest, then return again when you put weight
on your foot or resume activity. The area around the fracture may swell,
although you probably won’t see any bruising, and you’ll likely have
pinpoint pain there as well.
Your podiatrist has heard many, many stories about the breaking of bones,
but he’ll want to hear your story as well. Whether your break happened
suddenly like Paula’s or Gordon’s, or over several days (like Helen’s) or
months, your podiatrist will want to hear about it all. Give him or her
information about where your pain is located, how long it’s been going on,
and any other symptoms you’ve noticed (like swelling or bruising). Also let
your podiatrist know if anything seems to help the pain or make it worse.
To get to the heart of your story, your podiatrist will probably want to
take a look at your foot, both outside and inside. X-rays are often helpful
for traumatic breaks, although stress fractures tend not to show up until
after they’ve already started healing (usually after two or three weeks).
Your podiatrist may be able to determine you have a stress fracture just
based on your examination and medical history, although he or she may also
choose to order a bone scan to find out for sure.
Stress fractures of the metatarsals are often treated conservatively with
rest and immobilization of the bone. You’ll want to avoid doing the
activity that caused the stress fracture in the first place. (For instance,
Helen will want to take a break from marathon training). Your podiatrist
may have you wear a stiff-soled shoe or a cast to allow your bones to heal.
You may also need to use crutches or a wheelchair for a while to avoid
putting stress on your healing bone.
Fractures of your toes can be treated using a variety of methods. Rest will
likely be helpful (in other words, try to stay off your feet as much as you
can), and stiff-soled shoes can protect the broken bones and keep things
aligned. Your podiatrist may also put a splint on your broken toe, or may
buddy-tape the broken toe to an uninjured toe, with some gauze in between
to absorb moisture. (You’ll need to change the gauze and re-tape from time
to time as needed.)
Surgery is sometimes necessary, particularly if the fracture is in a place
that doesn’t heal very well, is badly displaced (has moved from its proper
location), or if it fails to respond adequately to conservative treatment.
Your surgeon may use pins, screws and plates to keep the pieces of bone in
place while they heal.
There are many stories about broken bones, and while they’re not fun when
they happen, you’ve got to admit that they make amusing anecdotes (when
told a long time after the event itself, of course). But really, the person
who decides whether your story has a happy or unhappy ending is you. Be
sure to follow your podiatrist’s instructions for the best possible outcome
for your injury.
Call 719-543-2476 today to schedule your appointment!