Toe & Forefoot Fractures

The forefoot is the front of the foot that includes the toes. Fractures occurring in this part of the foot are painful but not often disabling. There are two main types of foot fractures: traumatic fractures and stress fractures. Stress fractures are tiny hair line cracks in the bone, most commonly caused due to repeated stress from overuse. Traumatic fractures can occur when there is a direct impact to your foot, such as dropping a heavy weight on it, or an indirect force such as catching your foot in a pothole and twisting.

Several types of fractures can occur in the 5th metatarsal, which is the long bone on the outside of your foot that connects the midfoot to the little toe. A twisting injury to the ankle can sometimes break off the base of this bone, which is attached to one of the ankle tendons. Ballet dancers can break this bone when falling from the en pointe position. A fracture at the base of the 5th metatarsal that goes into the 4th/5th intermetatarsal joint is called a Jones fracture, and the blood supply to the bone is often disrupted in this injury. As such, it often takes longer to heal or requires surgery.

What are the symptoms of a fracture?

The symptoms of toe and forefoot fractures include pain, swelling and sometimes bruising. Many people can walk with these fractures, but it’s usually painful to do so.

How are fractures diagnosed?

To detect toe and forefoot fractures, your doctor takes a history of the injury and conducts a physical examination of the foot, and may order X-rays to identify the location and severity of the fracture.

How are these fractures treated?

Toe and forefoot fractures can be treated by the following ways:

  • Rest: Adequate amount of rest can sometimes help heal a traumatic fracture.
  • Splinting: Splints may be applied to keep the toe in a fixed position.
  • Rigid shoe: A stiff-soled shoe may be recommended to protect the toe and position it correctly.
  • Buddy taping: The fractured toe is taped to the adjacent toe with a gauze pad between the toes.
  • Surgery: Your doctor realigns the fractured bones using pins or screws to hold the bones together in place until they heal completely.

Stress fractures are primarily treated with rest and cessation of the activity that triggered the injury. Three to four weeks off impact sport is usually required, but this can be substituted with other non-impact activities like swimming, exercise bike and elliptical training.

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