Lesser Toe fractures

  What is a proximal phalanx fracture?

The phalanges are the bones that make up the toes.

A proximal phalanx fracture is a break in the first bone of the toe, closest to the foot.

These fractures commonly occur after stubbing, twisting or crushing the toe.

What symptoms and signs might I experience?

• Pain.
• Swelling.
• Bruising.
• Tenderness.
• Difficulty walking.
• Difficulty wearing shoes.
• A crooked or rotated toe if the fracture is displaced.

How is it diagnosed?

An X-ray is usually sufficient to diagnose the fracture and assess its alignment.

How is it treated without surgery?

Most simple, well-aligned fractures heal without surgery

Treatment may include:

• Supportive footwear.
• A stiff-soled shoe.
• Buddy taping where appropriate.
• Activity modification.
• Elevation.
• Pain relief.
• Gradual return to normal activity.

When might surgery be considered?

Surgery may be required if:

• The fracture is significantly displaced.
• The toe is rotated or significantly angulated.
• The fracture involves a joint and is significantly displaced.
• The fracture cannot be maintained in an acceptable position.
• There is an open fracture or associated injury.

What might surgery involve?

Surgical intervention is uncommon, but the fracture may be manipulated into position and held with:

• Wires.
• Screws.
• Plates or other fixation devices in selected cases.

What is recovery like?

Most uncomplicated toe fractures heal over several weeks.

Swelling, stiffness and sensitivity can persist for longer, particularly when returning to normal footwear.