Toe and forefoot fractures

Toe and forefoot fractures

Toe and forefoot fractures are breaks that occur in the small bones of your feet. About one-fourth of all your bones are located in your feet. A break or fracture in the forefoot or one of your toes  can be very painful, but it is rarely debilitating. Toe and forefoot fractures often can heal without surgical treatment.

There are three main parts of the foot:

  • Hindfoot – Consists of the heel bone and the talus, a small bone between the heel bone, or calcaneus, and the lower leg bones (tibia and fibula).The hindfoot primarily absorbs shock and displaces it forward and side to side.
  • Midfoot –  comprised of the small bones between the heel and the toes. This part of the foot also displaces force to either side of the foot.
  • Forefoot – Consists of the toes and primarily serves the purpose of pushing the foot off the ground to prepare for the next step.

Symptoms

The most common signs of a fracture in the toe or forefoot are:

  • Pain
  • Swelling
  • Discoloration
  • Bruising
  • Difficulty walking
  • Changes in walking

If the pain, discoloration and swelling continue for longer than three days, you should consult your doctor. Toe and forefoot fractures can change the way you walk, which could lead to further injuries.

Types

  • Stress fractures – The most common type of fractures that occur in the forefoot, these are tiny cracks in the bone surface and can occur as a result of a sudden increase in exercise, improper walking or running techniques or changes in exercise surfaces.
  • Fractures that extend through the bone – Most fractures extend through the bone instead of remaining on the surface as a stress fracture does.
  • Stable fractures – Generally don't cause any shift in the bone alignment.
  • Displaced fractures – This type of break shifts the alignment of the bone. It is often caused by trauma or injury such as dropping a heavy object on your foot or twisting your foot beyond its normal range of motion.
  • Closed fractures – The term for a fractured bone that does not break through the skin.
  • Little toe fractures – Several types of fractures occur on the side of the little toe, also known as the fifth metatarsal. This is a common area of injury for ballet dancers as they fall from a pointe position or experience a misstep in their routine.
  • Ankle-twisting injuries – Can cause a toe or forefoot fracture. During this injury the tendon that attaches to the fifth metatarsal bone is torn and may even pull away a small piece of the bone with it.
  • Jones fractures – One of the most serious injuries of the toe and forefoot area. It occurs near the base of the toe and occurs in an area of bone with poor blood supply. A Jones fracture can take much longer to heal and can possibly even require surgical treatment.

Treatments

Treatments for toe and forefoot fractures depend upon the severity of the condition. They can range from immobilization and realignment of the fractured bone to surgical fixation of toe and forefoot fractures. Most fractures of the toe and forefoot are simple non-displaced fractures and can be treated without surgery. However, displaced fractures and those that occur from significant trauma commonly require surgical fixation. For evaluation consult your orthopaedic surgeon.

The multidisciplinary team of foot experts at Northwell Health Orthopaedic Institute treats toe and forefoot fractures as well as a broad range of foot and ankle conditions that can occur at any stage of life.

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