Broken Toe (Fractured Toe)

What is a broken toe?

A broken toe, or toe fracture, is a common injury. The bones in your toes are tiny and vulnerable, so they can break easily. Even though these bones are small, injuries to them can be quite painful. In addition, all the bones in your feet and toes work together when you walk. So, when you break one, it can affect how your feet function.

In most cases, broken toes will heal on their own with rest and some at-home care. But you should see a healthcare provider to evaluate your injury if pain or swelling are severe. More significant injuries may require further medical treatment. Although rare, this may include manipulation to realign your toe in your provider’s office or even surgery.

Types of toe fractures

Foot and ankle surgeons divide toe fractures into two categories: traumatic fractures and stress fractures.

• Traumatic fractures: A direct blow or impact to your toe can cause a traumatic fracture. Also called an acute fracture, this type can be displaced or nondisplaced. Displaced means the end of the bone has partially or completely separated, causing it to change position. Nondisplaced means the bone has a crack, but the end of it hasn’t separated.
• Stress fractures: Repetitive stress on your toe can cause a tiny hairline break called a stress fracture. While this type of fracture commonly affects athletes, health conditions and other factors can also cause them. You shouldn’t ignore a stress fracture. You’ll need proper medical attention for it to heal properly.

Healthcare providers also classify toe fractures as closed or open:

• Closed fracture: When your wound hasn’t broken through your skin, you have a closed fracture.
• Open fracture: When your wound breaks through your skin and extends down to your bone, you have an open fracture. This type can be serious because bacteria can enter the wound through the open skin and cause an infection in your bone.

What are the symptoms of a broken toe?

The most common signs of a toe fracture are throbbing pain and swelling. Other broken toe symptoms may include:

• Inability to bend your toe or touch it without pain.
• Inability to walk or put any weight on your foot.
• Numbness or tingling.
• Bruising or discoloration under your toenail that may extend to other parts of your foot.

With a traumatic fracture, you may hear a sound when you break it. Your toe may look crooked or have an abnormal appearance. With a stress fracture, you may have swelling but no bruising. The pain may go away when you’re resting but come back when you stand or return to activity.

What causes toe fractures?

Toe fractures often result from a direct blow, injury or trauma to your toe bone. This may be from dropping a heavy object on your foot, kicking something really hard or seriously stubbing your toe.

Fractures may also develop after overuse and repetitive activity, instead of a one-time injury. These are called stress fractures. Stress fractures often affect athletes that participate in high-impact sports like football and basketball. They also frequently occur in runners. Other causes of stress fractures include:

• Abnormal foot structures or deformities.
• Health conditions like osteoporosis.
• Wearing shoes that are too tight or too loose.

What are the complications of toe fractures?

If you think you may have a broken toe, it’s important to see a healthcare provider as soon as possible. Without treatment, a broken toe can lead to complications, including:

• Chronic foot pain.
• Bone deformity.
• Foot and ankle arthritis.
• Difficulty walking.
• Need for future surgery.

How are broken toes diagnosed?

Your healthcare provider will ask about your symptoms and medical history. They’ll want to know how you injured your toe. They’ll also perform a physical exam, which involves:

• Looking for any swelling, tenderness or bruising.
• Comparing your feet to look for any deformities.
• Inspecting any open wounds or skin abrasions.

What tests will be done to diagnose this condition?

Your provider may be able to diagnose a broken toe based on the physical exam alone. However, sometimes, they request imaging tests. These tests may include:

• Foot X-ray: Providers can usually see traumatic fractures on a routine X-ray. But stress fractures start as tiny cracks and may not be visible on an X-ray.
• Magnetic resonance imaging (MRI) scan: If your provider thinks you may have a stress fracture but can’t see it on an X-ray, they may request an MRI.

What do you do for a broken toe?

If you have painful symptoms of a broken toe that impair your mobility, you should see a healthcare provider and get an X-ray. While you’re waiting to see your provider, you can do the RICE method at home.

The RICE method involves Rest, Ice, Compression and Elevation:

• R – Rest: Stop participating in any sports or other physical activity that causes pain. Keep your foot immobile as much as possible and try to limit how much weight you put on it.
• I – Ice: Wrap ice in a thin towel and apply it to your injured toe for 20 minutes at a time to help reduce swelling. Don’t apply ice directly to your skin.
• C – Compression: Lightly wrap your toe in a soft, compressive dressing. Don’t wrap too tightly.
• E – Elevation: Rest with your foot raised slightly above your heart to help with the swelling.

You may also take pain medication as necessary. You can use nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, or acetaminophen (Tylenol®). Don’t give aspirin to children.

You may find it painful to wear regular footwear. Wearing a wider shoe than normal may be more comfortable.

In-office treatment

Broken toe treatment depends on the location of your injury and the type of fracture. Your provider may recommend:

• Buddy taping: With buddy taping, your provider will wrap a piece of tape around your broken toe and the one next to it (the buddy) to help relieve pain and keep your toe stable. Then, they’ll place a small cotton wad between your toes to prevent moisture. You should change the cotton out daily.
• Special shoes: Your provider may recommend a rigid, stiff-bottomed shoe to make room for swelling, help protect your toe and keep it properly positioned. When the swelling goes down, make sure to wear a solid, stable shoe or a boot walker.
• Manipulation: If your toe is crooked or looks out of place, your provider may need to manipulate, or reduce, your fracture. With this procedure, your provider will first numb your foot using a local anesthetic. Then, they’ll realign your fracture by straightening your toe and putting it back into place.
• Trephination: With this procedure, your provider will make a small hole in your toenail using a needle or an electrocautery device to release blood that has collected under your nail.
• Surgery: If you have a severely displaced fracture or it’s affecting a joint, your provider may recommend surgery. Surgery for a broken toe usually involves a surgeon using fixation devices like pins.

Can broken toes be prevented?

Because traumatic fractures are due to accidents and injuries, they’re difficult to prevent. However, there are several steps you can take to try to prevent stress fractures:

• If you start to feel any pain while exercising or participating in sports, immediately stop. Don’t try to “play through the pain.”
• Warm up and cool down before any exercise, sports or other physical activities.
• Wear the correct footwear for all sports and physical activities.
• Wear footwear in your home.
• Take vitamin D3 for good bone health.
• Maintain a healthy weight for you.
• Seek treatment from a healthcare provider if you notice any pain or other symptoms.

How long does a broken toe take to heal?

Your initial pain and swelling should go away within a week. Most broken toes take six to eight weeks to heal completely. Depending on the severity of your condition, it could take longer. Your foot could remain swollen for several months.

When can I go back to my normal activities?

Your healthcare provider will let you know when it’s safe to return to sports and resume your normal activities. But you should be able to return once your swelling has gone down and you can comfortably wear supportive shoes. Gradually increase the amount of physical activity you do each day.

You may experience some stiffness and soreness when you walk. But this should go away when your toe muscles start to stretch and strengthen. If you begin to experience any new pain, you should stop what you’re doing immediately and reach out to your provider. You don’t want to risk reinjuring yourself.

When should I see my healthcare provider?

If you notice any of the following symptoms, reach out to your healthcare provider:

• Sudden tingling or numbness.
• Sudden increase in swelling or pain.
• Bleeding or an open wound.
• Fever or chills.
• Red streaks on your toe.
• Crooked or bent toe.
• Slower-than-expected healing.

If you sought treatment for your broken toe, you’ll want to follow up with your healthcare provider one to two weeks after your injury. If you have a severe injury, your provider may want to see you more frequently.

What questions should I ask my healthcare provider?

Questions you may want to ask your healthcare provider include:

• What treatment do you recommend for a broken toe?
• What can I do at home to alleviate my toe pain?
• When can I get back to my usual activities?
• How can I prevent a broken toe in the future?

A note from Cleveland Clinic

Ouch! You just banged your toe against the door as you were running into the house. Is it broken? Once the pain subsides, you may brush it off and move on to the next thing. It’s just a toe, right? Take another look. While tiny, the bones in your toes are a vital part of how your feet function. You need them working properly to walk, play sports and participate in the other activities you love. So, get some rest, and make a call to your healthcare provider to have any potential toe fractures checked out.