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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Medical
Satisfied Customers: 6535
Experience:  14 years experience in the field of Family Practice
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I stubbed my small toe on my right foot last night. It look

Resolved Question:

I stubbed my small toe on my right foot last night. It look a bit bent, but that may be the way it always looked. Some pain, but not a lot. A little swelling. How do I know if I broke it or not, and how important is it that I seek medical attention quickly; e.g. is it ok to give a few days to see if it gets better or is X-ray imperative now. Thanks.
Submitted: 1 year ago.
Category: Medical
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

I would expect that you would have pretty severe pain with walking if you had a fracture of the toe. You are right in that the small toe of the foot is not the highest priority when it comes to fractures and treatment. It would be treated by placing you in a firm bottom walking boot if you needed it... this would help to stabilize it and would reduce pain.. it would help in the healing process if you needed this...

I would advise that you see how you feel and keep a close watch on the degree of pain and swelling over the next couple of days... if the pain is not that bad with walking then you probably don't have a fracture..

If a fracture then a closed and non-displaced fracture would be the most common BUT your report that it looks bent does sound more suspicious that you may have a closed but displaced fracture (this means it did not break the skin and that the bone is more than just cracked but still in position >> this would mean that the bone is angulated out of position...)

Buddy taping the 5th and 4th toes together is often a means of assisting treatment.

I would advise that you rest // stay off the foot to extent possible?? elevate the foot // take an anti-inflammatory to help with pain and swelling...

I would encourage you to NOT FEAR having this seen about and treated.. it is not a huge deal.. also treatment of this will only help if it should be fractured.. the x rays and treatment of a fractured toe is not a big deal either...

I hope this information helps! Let me know if you have further questions! I will be happy to get back with you!!

If my answers have been helpful and to your satisfaction then please remember to leave positive feedback! That would be very much appreciated! Thank You and Best Regards,

Anthony Bray MD
Anthony Bray, MD, Doctor
Category: Medical
Satisfied Customers: 6535
Experience: 14 years experience in the field of Family Practice
Anthony Bray, MD and 5 other Medical Specialists are ready to help you
Customer: replied 1 year ago.

I had x-rays taken this afternoon.

What do you mean by, "You may have a closed but displaced fracture (this means it did not break the skin and that the bone is more than just cracked but still in position >> this would mean that the bone is angulated out of position." (How can it be still in position but angulated out of position?)

My pain is not severe; I can walk but my toe is inflamed (not bruised) and when I put on shoes can feel discomfort. With these symptoms, could I have the above or unlikely?

And if I had the above what would be the treatment. Thank you.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Sorry for the poorly worded phrasing >> let me clarify >>

Non-displaced fracture = still bone aligned

Displaced fracture = bone out of proper alignment

Open fracture = skin broken as part of injury and so infection becomes concern..

Closed fracture = skin remains intact >> not susceptible to infection

If you had x ray and this was normal then that is great >> you would not need to worry about the issue of allowing a fracture to heal !! Still you may have soft tissue injury and possibly some injury of joints of the toe...

If you had a closed displaced fracture (I wondered about this possibility as you said the toe appeared bent...) Then treatment would probably simply include buddy taping 5th and 4th toe and using a walking boot with firm sole to prevent toe bending with walking...


It sounds that you may just have soft tissue injury ( you mention above that you had x ray yesterday >> have you received report on this yet??) If only soft tissue injury just need to try and rest and stay off foot to extent that you can... elevate the foot ...take an anti-inflammatory med such as Aleve 1 to 2 tabs with food twice a day..It should settle down and show improvement in only a few days...

I hope this helps>> Let me know if you have further questions ! I will be happy to get back with you! Best Regards,

Anthony Bray MD
Anthony Bray, MD, Doctor
Category: Medical
Satisfied Customers: 6535
Experience: 14 years experience in the field of Family Practice
Anthony Bray, MD and 5 other Medical Specialists are ready to help you
Customer: replied 1 year ago.

Could you please interpret this radiology report of an x-ray for diagnosing stubbed right small toe? Is this about as benign as a fracture can be?


 


I received this on-line today for injury sustained last Thursday. X-rays were taken the next day. My doctor has not added any addtional info to the results. Will ask new question regarding recommendation. Thank you.


 


PROCEDURE: XR FOOT 3 OR MORE VIEWS RIGHT, 5/3/2013 4:02 PM


 


LOCATION: SSSADIXA


 


COMPARISON: None


 


CLINICAL INDICATION: patient wanting xray of foot to eval


trauma to 5th toe.


 


TECHNIQUE: 3 views right foot


 


FINDINGS:


 


Osseous Structures: There is a slightly displaced fracture of the fifth proximal phalanx. The distal fracture fragment is angulated laterally. The fracture does not appear to be intra-articular. No significant degenerative changes. No osseous lesions are visualized.


Soft Tissues: Soft tissue swelling of the fifth toe is present.


 


No significant tibiotalar joint effusion.


 


IMPRESSION:


 


Acute fracture of the fifth proximal phalanx.


 

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!

You have a fracture of your little toe. It is more than just a crack in the bone but it is only mildly displaced. So this means that the bone is mildly bent from its normal position. You would do best to have this cared for by an orthopedic specialist. It sounds that you will simply need to have the fourth and fifth toe buddy taped and to be placed in a walking boot. As I said before these measures would help to stabilize the bone, promote healing and reduce pain. You would benefit to take ibuprofen 2 to 4 tablets three times a day to help curb inflammation and pain. Rest and stay off the foot to the extent that you can. Keep the foot elevated.


I hope this information helps. Let me know if you have further questions! I will be happy to get back with you! Best regards,

Anthony Bray MD
Anthony Bray, MD, Doctor
Category: Medical
Satisfied Customers: 6535
Experience: 14 years experience in the field of Family Practice
Anthony Bray, MD and 5 other Medical Specialists are ready to help you
Customer: replied 1 year ago.

 


Thank you for your prompt and comprehensive responses.


 


When you state that it is more than a crack what do you mean?


 


I have been taping with Micropore tape, wrapping it around the base of all my toes. I was told the fracture was in the lower part of the toe. Can you determine that from the radiologist's report. When the nurse wrapped just the small toe and adjacent toe together, it had more pain. For whatever reason, she did not wrap the base of the toe, and told me to do that later. Regardless, should I do the buddy taping, or is entire toe method acceptable? Even when I wrap the entire foot, the more snug the taping the more pain.


 


I never had acute pain, even when first injured. It was more the location of the two (about 2 o'clock) that had me suspecting a possible fracture.


 


However, it is now a week, and I still have mild pain. The urgent care doctor recommended I wear shoes to stabilize the toe. I was wearing Adidas County tennis/running shoes (leather not nylon), but he said they were pretty hard and should be sufficient.


 


I only iced for a day or two, and just taken ibuprofen intermittently the first couple days. I will resume that due to inflammation more than pain; as of Tuesday the toe was still swollen, but it never had any bruising.


 


Should I ice at this point? I am home due a UTI and am taking Cipro 250mg twice a day.


 


I set up an appointment with a podiatrist on the earliest date available, Monday afternoon.


 


Appreciate observations and any further recommendations, including questions to ask the podiatrist.


 


Thank you!

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,When I say it is more than a crack , this is very literal. The liberty bell has a crack in it but the shape of the Object is the same. With the bone you can have JUST a crack with no displacement if the bone. You have more than this as you have MILD DISPLACEMENT----the bone is angled off center due to the break---The podiatrist should be helpful in reviewing your care plan. The buddy taping I agree with. I think that you may benefit some further with a post-op walking boot ( the sole is so firm with these that there is NO BEND OR GIVE TO THEM -- this helps to further stabilize the toe to promote healing) the FIRMER the sole the better to help stabilize the toe. You will need to be careful with the toe for about six weeks. It typically takes this long for a fracture to heal.I hope that this is helpful for you! Let me know if you have further questions. I will be happy to get back with you. Best regards,Anthony Bray MD
Anthony Bray, MD, Doctor
Category: Medical
Satisfied Customers: 6535
Experience: 14 years experience in the field of Family Practice
Anthony Bray, MD and 5 other Medical Specialists are ready to help you

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