Lesser toe fractures are common.
They usually occur after kicking something and catching the toe or from a crush injury.

Fractures may involve the joint.

Patients present with pain , swelling and in some cases deformity of the toe.

What is the non surgical treatment?

The majority of toe fractures can be successfully treated without the need for surgery.

Treatment may include:

  • Pain relief
  • Buddy strapping- using tape to strap the injured toe to the toe next to it, to create a splint.
  • Stiff soled post operative shoe
  • Carbon fibre insert

How long is the recovery?

Clinical healing is evidenced by reduction in pain and a reduction in swelling.

By 6 weeks from injury the strapping and stiff soled shoe should be no longer required and patients are back to household activities.

A return to all activities including sport may take 12 weeks.

Swelling of the toe may last for 6-9 months and in some cases it may be permanent.

Do I need repeat xrays?

Toe fractures can take a long time to heal on xray. In some cases the fracture may not heal.

Repeat xrays are only needed if there is a change in symptoms or a change in position of the toe.

As long as the toe is not painful and not limiting footwear or function no further investigation or treatment is required.

When is surgery considered?

  • Significant deformity
  • Involvement of the MTP joint
  • When the toe continues to be symptomatic after non operative treatment
    • Due to non healing
    • Due to deformity

What does surgery involve?

  • Open reduction internal fixation
  • Joint fusion
  • Osteotomy of the toe to correct deformity

What implants are used?

  • Screws
  • Intramedullary implant
  • Wires which sit outside of the toe for 6 weeks

What does the rehabilitation involve?

  • Day surgery
  • Elevation and rest for 2 weeks to allow wound healing.
  • Full weightbearing as tolerated in a post operative shoe which is worn for 6 weeks.
  • Review at 2 weeks for suture removal.
  • Removal of wires if used at 6 weeks
  • Physiotherapy in some cases to assist maintenance of joint motion.
  • By 6 weeks managing activities around the house.
  • By 3 months back to recreational walking.
  • Final result with resolution of swelling 6-9 months.

How long will I be off work?

This is dependent upon your occupation

  • Seated job 2 weeks
  • Standing job 4-6 weeks
  • Heavy lifting job 8-12 weeks

When can I drive?

  • Manual car
    • No driving for 6 weeks
  • Automatic car
    • Left foot no driving for 2 weeks
    • Right foot no driving for 4 weeks

What are the risks of the procedure?

General risks of surgery

Infection

  • Wound healing problems
  • Nerve injury and scar sensitivity
  • Blood clots to the leg
  • Anaesthetic problems

Specific risks for lesser toe surgery:

  • Incomplete pain relief
  • Persistent swelling of toe or foot
  • Early pull out of the wire
  • Non union of fusion and implant failure
  • Incomplete correction of deformity
  • Recurrence of deformity
  • 10% chance of requiring further surgical correction
  • Loss of blood supply to toe resulting in partial or complete toe amputation (rare)
This information is an overview of the management of lesser toe fractures and is not all inclusive.

If you have any questions please contact Mr Curry’s rooms on (03) 99286560