A broken toe is a very common occurrence. Most commonly, you hit your toe on a piece of furniture in the dark of night. You hit that toe and very quickly see stars. My name is Dr. Andrew Schneider, and I'm a podiatrist in Houston, TX. For other broken bones in your foot or ankle, I may put you in a special shoe or boot until the bone is healed. In today's video I'm going to discuss if wearing a shoe or boot is necessary for a broken toe.
It's like there's a secret magnetism to attract a barefoot to hit a heavy, solid chair or nightstand that you run into while innocently heading towards a restroom at night. Sound familiar? Of course there are other causes of a broken toe, but this is the most common story that I hear.
The thing is, if you ask most people, they'll tell you there's nothing you can do for a broken toe. They just suffer through the pain and hope that time will take care of it. Can you think of another broken bone where the most common suggestion for the best treatment is to do nothing? Why is this the case for a broken toe?
Your toes are important. They're responsible for propulsion as you're walking. They're responsible for balance when you're standing. That's why a broken toe is so painful. Your toes are responsible for a lot. It's important to get an x-ray to see if you broke your toe and if so, what kind of position it is in.
So let's say you break your toe and do nothing to treat it. On one hand, the broken toe can be an excellent position and heals perfectly fine. On the other hand, you may find the fractured ends are not in good alignment. If that's the case, it won't heal properly. This can cause the toe to have lasting changes. Letting a toe heal in a poor position can cause a toe to buckle, like a hammer toe. The bone can protrude out the side of the toe like a bone spur. If the joint is affected, it will lead to the toe becoming stiff. All of these issues can cause lasting pain and problems.
What if I told you that there is something you can do for a broken toe? it's possible for the fractured toe to be in an excellent position. It should heal uneventfully. That said, the bone fragments can shift as you walk. To avoid this from happening, I recommend that you buddy splint the broken toe to an adjacent toe. This will stabilize the toe and protect it from being displaced.
What if the x-ray shows the bones of the toes not in a good position? Toe fractures are easily manipulated to get them back into a proper position. I'll numb the toe and apply traction to it. In most cases, this will reduce the fracture. I'll confirm it with another x-ray. Once the fractured bone is in good position, I'll buddy splint it and you'll treat the toe how you would if it was always in good position. If the toe fracture doesn't reduce by manipulating it, the fracture may need to be reduced surgically. This is very rare for a broken toe.
Of course, the question at hand is, do you need to wear a special shoe to treat a broken toe? The answer is no...and yes. Let me explain working backwards. If you have to have surgery to correct the toe fracture, then you will wear a surgical shoe for about 3 - 4 weeks after surgery. That is pretty standard for any toe surgery.
In the other cases where the toe is in good position, or the toe was manipulated to realign the fractured bone, then you may or may not need to wear a special shoe. The deciding factor is if you are able to comfortably wear a closed shoe. The buddy splint provides a good amount of stability for the broken toe. If you're able to comfortably fit into a closed shoe, you may do so. Some people find it more comfortable with less pressure on the toe. In these cases, I'm happy to dispense a surgical shoe for them to wear.
One difference is if you break your great toe. In these cases, I usually do immobilize you in a surgical shoe or fracture walker. The great toe has a lot of pressure coming through it, and we have to ensure that it heals perfectly to prevent future problems. I hope you now realize that, indeed, a broken toe is something that should be addressed.