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Toe Fractures and Dislocations: The Other Pandemic

You won't believe what we have been seeing at a significantly increased rate in our office. There's a good chance you might have experienced it yourself!

For the past year, state regulations due to the COVID-19 pandemic have kept people in their homes, where they been obliged to find new ways to carry on normal life. Whether you have made new habits for work, exercise or leisure activities at home, there is a good chance that one or two times...or every time...you have done it without your shoes on, which you might not have done out in public. 

And if you are one of those people that has kicked off your shoes and relaxed a bit, there is also a good chance that you are one of the many patients we have been seeing in recent months complaning of a broken toe. I am not kidding! I do not have the numbers, but any foot or ankle specialist can tell you that in this past year, the incidence of toe fractures has gone up significantly. This is solely because people have been spending much more time at home, and most people like to have their shoes off to relax. Inevitably, being at home all the time without shoes on, there are going to be accidents. 

What causes a toe to break?

Generally, some form of trauma. Most commonly it will be due to either something heavy falling on your toe, or stubbing the toe into a hard surface like a door, a step, a wall, or furniture. 

How will you be able to tell if my toe is broken?

First, a physical exam will show swelling, bruising and tenderness associated with the affected toe. Range of motion will be limited due to pain. We would need to take an x-ray to see the extent of the fracture, which will help in selecting the proper treatment. We will be able to see if there has been any dislocation of one of the joints in the toe, as well as displacement of any fracture fragments.

How do you treat a broken toe?

Most often a broken toe will heal fine on its own with the proper conservative therapy. Buddy-taping the toe to an adjacent toe, while wearing a post-op shoe is the mainstay in therapy, but if there has been a dislocation of one of the joints of the toe, closed reduction (popping it back into place) will need to be done as soon as possible. If there has been involvement of the toenail and it has turned dark blue or black, we may have to either make a small hole in the nail to drain the blood, or in some cases we will remove the nail entirely. Very, very rarely is surgery ever indicated for a broken toe, and that would be in the most devastating kind of cases. 

What does the long-term outcome look like?

If treated properly, pretty good! However, it really matters to get it checked out by a doctor because if there is any kind of dislocation of the toe or displacement of the fracture fragments, the risk of post-traumatic arthitis is very high. This can set you up to develop hammertoes, swelling, and discomfort that may require surgery after all. The best way to prevent this from happening is immediate examination and care. 

 

Author
Sam Meyers, DPM Samuel Meyers, DPM is a board-certified and fellowship trained foot and ankle surgeon at Aloha Foot and Ankle Associates in Mission Viejo, California. Dr. Meyers treats a broad range of foot and ankle conditions and is honored to help individuals living in and around Orange County get back on their feet. Dr. Meyers earned his B.S. in biological sciences at the University of California, Davis, and his Doctor of Podiatric Medicine (DPM) degree at the William M. Scholl College of Podiatric Medicine in North Chicago, Illinois. During his 3 year residency at DVA-Loma Linda, he met his wife, who is also named Sam! Afterwards, He completed a fellowship in advanced rearfoot reconstruction in Newport Beach. After his training was complete, Dr. Meyers joined the Aloha Foot and Ankle Associates team. Dr. Meyers lives in Coto de Caza with his wife, their dog and bunny. Under the monkier Double Sam Farms, Dr. Meyers and his wife have brought joy to their community with their two miniature alpacas, Autumn and Willow.

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