Do you have fractured hallux?

A fractured hallux usually occur as a result of severe impact and usually have associated bruising, but there are times you don’t have much bruising at all. If you think your toe is broken from running or repetitive stress, then it is likely just a sore bruised toe or a stress fracture, not a broken toe.
The only way to know for sure is to go in for an X-ray, because if the toe is not obviously deformed then it is impossible to know for sure. There are some tricks that may sway you one way or the other, but this is risky because ***If the fracture is serious and not properly healed – you will have permanent arthritis****.

Broken 1st & 2nd toe

Rough guide for a fractured hallux vs bruised hallux:

1) Feel for a deformity – if it is uneven it is a broken toe.
2) Wiggling your toe- if no severe pain or rubbing/popping sound, may not be a break.
3)If your toe is extremely swollen (2x the size)- it may be broken.
4)Compare that toe to your other foot, if it looks shorter or bent – it may be broken.
5)Check your temperature- after a break you are more likely to have the surrounding area inflammed.

Concerns of a bruised or fractured hallux

• Pain: Instant if fracture or gradual if a stress fracture from running.
• Swelling and Stiffness occur very quickly, the toe will not look normal.
• Blood under the nail called a subungual hematoma which needs be drained if swollen, or the nail could fall off and be abnormal for the rest of your life.
• An open fracture with a tear in the skin is extremely prone to infection and will need to be treated with antibiotics at the emergency room.
• ***If the fracture is not properly reduced – you will have permanent arthritis, it is better to play it safe and get it X-rayed if it looks really bad***
• Often with fractures of the smaller toes, the patient is not aware that they have a fracture.

When to call a podiatrist for a fractured hallux?

• Play it safe and go get an X-ray right off the bat, it probably does not need surgery or the re-attachment of ligaments, but better to be safe than sorry. Most people will get arthritis and pain for the rest of their life is it is even slightly displaced.
• If the pain is getting worse, especially after anti-inflammatory treatment and icing as described below.

When to go to the ER for a fractured hallux?

• Toes turn white, blue or gray colored- *Arterial injury*
• Numbness or tingling *nerve injury*
• Play it safe and go get an X-ray right off the bat, it probably does not need surgery or the re-attachment of ligaments, but better to be safe than sorry.

Treatment

Home treatment for a fractured hallux:

• Ice: This is not just about pain! It will decrease the inflammation and decrease the time needed to heal. Put ice in a bag and hold apply it for 15-20 minutes every 2hours or so for the 1st day. Leave some cloth inbetween the ice and the skin.
• Elevation: Like above, it is more than about pain. Recline in a chair and elevate our foot while watching tv, the more the better, elevation can take days or weeks off your healing time.
• Non-weight bearing: wearing a surgical shoe or using crutches increases the healing rate and potential. There are clinic trials that correlate a reduction in body weight to healing time and quality.
• Pain medication: Ibuprofen or other anti-inflammatories are great at reducing inflammation, again this is not just for the pain, but it decreases the swelling and increases the healing speed. Check the recommended dose for your drug of choice.
• Combine icing, elevation, non-weight bearing and pain medication gives you the best chance at healing as quickly as possible.
• If it is a small toe it is possible to tape the toes together with a piece of cotton in between to keep them from bending as much.
• Play it safe and go get an X-ray right off the bat, it probably does not need surgery or the re-attachment of ligaments, but better to be safe than sorry.
  

What a podiatrist can do for your fractured hallux

• Get an x-ray to check the severity of the broken or bruised big toe.
• Reduction of the bone under anesthesia.
• Surgical shoe, cast or pneumatic compression boot to help prevent non-union or malunion.
• Surgery if the bone is displaced to prevent arthritis or deformity.
• Play it safe and go get an X-ray right off the bat, it probably does not need surgery or the re-attachment of ligaments, but better to be safe than sorry.

To see more information about a fractured hallux see this link.