Management of Toe Fractures
A) Surgical referral
B) Cast and non weight bearing for 6 weeks
C) No treatment indicated
D) Rigid surgical shoe for 4 to 6 weeks
Image 3. Fracture of the proximal phalanx of the 5th digit with lateral dispalcement.
Outcomes & Complications
Answer is D. The vast majority of phalangeal fractures of the foot, or toe fractures, are non surgical. This is especially true of digits 2-5. In this case, the phalanx fracture is non displaced and there are no surgical indications. The treatment of choice is a rigid surgical shoe for support and protection for around 4 to 6 weeks. No treatment is incorrect and undertreating the injury. Cast and non weight bearing is over treating.
|↑1||Rennie, Louise, et al. “The epidemiology of fractures in children.” Injury 38.8 (2007): 913-922.|
|↑2, ↑4||Fife, Daniel, and Jerome I. Barancik. “Northeastern Ohio trauma study III: incidence of fractures.” Annals of emergency medicine 14.3 (1985): 244-248.|
|↑3, ↑7||Van Vliet-Koppert, Sabine T., et al. “Demographics and functional outcome of toe fractures.” The Journal of foot and ankle surgery 50.3 (2011): 307-310.|
|↑5||Venegas, L., J. J. Rainieri, and E. C. Rzonca. “Fracture of the fifth digit. An atypical presentation.” Journal of the American Podiatric Medical Association 85.3 (1995): 166-168.|
|↑6||Case courtesy of Dr Pir Abdul Ahad Aziz Qureshi, Radiopaedia.org, rID: 62584|