Symptoms of toe and forefoot fractures.

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

• Bruising or discoloration that extends to nearby parts of the foot
• Pain with walking and weight bearing
• Tenderness over the fracture site
• Deformity
• Skin abrasions or open wounds
• Loss of sensation—an indication of nerve injury

What is a toe and forefoot fractures?

Foot fractures

Fractures of the toes and forefoot are quite common. Fractures can result from a direct blow to the foot—such as accidentally kicking something hard or dropping a heavy object on your toes. They can also result from the overuse and repetitive stress that comes with participating in high-impact sports like running and basketball.

Although fracturing a bone in your toe or forefoot can be quite painful—it rarely requires surgery. In most cases, a fracture will heal with rest and a change in activities.

These come in three general categories:

Fractures to the toes: A fracture of the toe may result from a direct injury, such as dropping a heavy object on the front of your foot, or from accidentally kicking or running into a hard object.

A fracture may also result if you accidentally hit the side of your foot on a piece of furniture on the ground—and your toes are twisted or pulled sideways or in an awkward direction.

Metatarsal fractures: The metatarsals are the long bones between your toes and the middle of your foot. Like toe fractures, metatarsal fractures can result from either a direct blow to the forefoot or from a twisting injury.

Some metatarsal fractures are stress fractures. Stress fractures are small cracks in the surface of the bone that may extend and become larger over time.

Reasons to see a physician

If you think you have a fracture, it is important to see your doctor as soon as possible. A fracture that is not treated can lead to chronic foot pain and arthritis and affect your ability to walk.

While you are waiting to see your doctor, you should do the following:

• Apply ice to help reduce swelling.
• Elevate your foot as much as possible.
• Limit weight bearing.
• Lightly wrap your foot in a soft compressive dressing.

Treatment for foot fractures depends upon:

• The location of the injury
• The type of fracture

Non-surgical treatments

Most foot fractures can be healed without surgery some tupes of fractures and treatment options include:

Metatarsal fractures: most can be treated with an initial period of elevation and limited weight bearing. This is followed by gradual weight bearing, as tolerated, in a cast or walking boot. Surgery is not often required.

Toe fractures: Most broken toes can be treated symptomatically. For several days it may be painful to bear weight on your injured toe. As your pain subsides, however, you can begin to bear weight as you are comfortable. During this time, it may be helpful to wear a wider than normal shoe.

“Buddy taping” your broken toe to an adjacent toe can also sometimes help relieve pain.

Surgical treatments

Metatarsal fractures: However, if you have fractured several metatarsals at the same time and your foot is deformed, unstable, or if you have an open fracture surgery is necessary.

During the procedure, your doctor will make an incision in your foot, then insert pins or plates and screws to hold the bones in place while they heal.

Toe fractures: If the bone is out of place and your toe appears deformed, it may be necessary for your doctor to manipulate or “reduce” the fracture. This procedure is most often done in the doctor’s office.

Prevention methods and other tips

Some ways to help protect your feet from stress and acute fractures include:

• Use proper equipment. Old or worn running shoes may lose their ability to absorb shock and can lead to injury. Also, steel toe boots can protect your feet against falling objects if you are often in situations which have a risk of falling objects
• Start new activity slowly. Gradually increase your time, speed, and distance. In most cases, a 10 percent increase per week is appropriate.
• Cross train. Vary your activities to help avoid overstressing one area of your body. For example, alternate a high-impact sport like running with lower-impact sports like swimming or cycling.
• Add strength training to your workout. One of the best ways to prevent early muscle fatigue and the loss of bone density that comes with aging is to incorporate strength training. Strength-training exercises use resistance methods like free weights, resistance bands, or your own body weight to build muscles and strength.
• Stop your activity if pain or swelling occurs. Rest for a few days. If the pain continues, see your doctor.

Anatomy

The forefoot is made up of bones called the phalanges and the metatarsals.

The phalanges are the bones which make up your toes. These are smaller bones that are often fractured due to a direct injury from dropping a heavy object on them or kicking an object. However, they can also become injured if the toes are twisted in an awkward way.

Metatarsals: There are 5 metatarsals and they are the longest bones of the forefoot and consist of 4 parts:

• Head
• Neck
• Shaft
• Base

Similar to toe fractures they can be broken by direct blow or a twisting injury. Sometimes with metatarsal fractures they can also be stress fractures which build up overtime.

Recovery and return to activity

Healing of a broken toe may take from 4 to 8 weeks.

Metatarsal fractures usually heal in 6 to 8 weeks, but may take longer. Your doctor will take follow-up x-rays to make sure that the bone is properly aligned and healing. Even with proper healing, your foot may be swollen for several months and it may be hard to find a comfortable shoe.

Your doctor will tell you when it is safe to resume activities and return to sports. If you experience any pain, however, you should stop your activity and notify your doctor. Returning to activities too soon can put you at risk for re-injury.