Quick treatment is critical

Most people think that there’s nothing that can be done about a broken toe but grimace. Not true. The majority of broken toes heal without treatment, but even minor fractures can shed bone fragments that cause persistent irritation. A greater risk is that the toe will heal in a “malaligned” position, causing arthritis or balance problems later in life.

Important: Toe fractures should always be seen by a podiatrist or orthopedic specialist. Fast treatment helps ensure that the bone heals quickly and in the normal position.


Assume that a toe is broken when an injury causes bruising. The toes have less circulation than other parts of the body. If the toe is black and blue, it’s almost certainly broken.

Three types of breaks…

  • Hairline (stress) fracture, a small crack in the bone, is the least serious. It usually heals well on its own.
  • Spiral fracture is caused by twisting injuries, such as catching a toe on a nightstand or a piece of luggage. This type of break typically is complicated by bone fragments.
  • Compound fracture means that the bone has broken completely. It’s the most serious fracture.


Compound fractures require surgery, both to stabilize the bone and clean the area to prevent infection. Other fractures, which may or may not be visible on X-rays, usually can be treated nonsurgically.

Right after the injury, take these steps (abbreviated as RICE): Rest to protect the damaged tissue… ice (wrapped in a thin towel to protect the skin) to reduce pain and swelling — 10 minutes on, 20 minutes off… compression with an elastic bandage to stabilize the area… and elevation, raising the foot above the level of the heart to reduce swelling.

Over-the-counter pain relievers often are sufficient to relieve pain. Take one that also reduces inflammation, such as aspirin or ibuprofen. You also may need…

  • Reduction. When X-rays show that the two ends of the fracture aren’t likely to knit together, the doctor may need to manipulate the bones. This procedure, known as reduction, usually can be done externally. It’s painful, so you’ll probably be given an injection of anesthetic.
  • Buddy splint. To keep the area stable, I use a buddy splint, in which the injured toe is loosely taped to an adjoining toe to keep it from moving. Gauze is put under the tape, between the toes, to prevent chafing.

Helpful: If both toes move together when you wiggle the uninjured toe, the splint is working properly.

You also should wear a stiff-bottomed shoe (known as a postoperative shoe) to keep the toe from flexing. They’re available in most pharmacies.

Cost: About $20.

In young adults, a broken toe typically heals in four to six weeks. For those in their 60s and older, the usual healing time is eight to 10 weeks.

Important: See a doctor right away if you develop subungual hematoma, a collection of blood under a toenail that looks like a purplish bruise. Pressure from the trapped blood forces the nail upward and increases the risk for infection. It also can cause the toe to be permanently malformed. The doctor will open a hole in the nail with a needle or cautery device to drain the blood.