Introduction
This information is for patients who have attended University College Hospital (UCH) Emergency Department with an undisplaced or minimally displaced, extra-articular toe fracture (broken bone). It is not for big toe injuries.
Extra-articular means the joint is not affected. Undisplaced means that the broken bone is not out of place. Minimally displaced means that the broken bone is not significantly out of place. Minimally displaced and undisplaced fractures do not need a manipulation. Routine follow up is also not usually needed for these injuries.
This information provides advice on how to care for your injury and what to expect with your recovery.
Managing pain and swelling
Your injured foot may be swollen. Swelling is often worse at the end of the day or when your foot is hanging down. Resting and elevating the injured foot (with your ankle raised above the level of your hips if possible) will help reduce swelling. Pillows or a stool can be used to keep the foot up. You can take simple pain killers (such as paracetamol) as prescribed. Avoid regular use of non-steroidal anti-inflammatory drugs such as ibuprofen or naproxen.
Cold pack/Ice pack
An ice pack can provide short term pain relief and reduce swelling. If you do not have an ice pack, you can make one by putting ice in a plastic bag and then wrapping this in a clean, damp towel. Apply the ice pack to the sore area for up to 15 minutes, a maximum of 4 times a day, using a clean towel each time. Do not directly apply the ice pack to your skin.
WARNINGS:
• Do not use ice if you have poor circulation, or problems with sensation.
• Beware of putting ice over your finger tips and toes.
• Do not leave ice on for too long as it can burn or reduce your circulation.
• Check the skin regularly.
Walking
You can take your full weight through the foot as comfort allows, wearing a stiff soled shoe or sports shoe. However, you may find it more comfortable to take weight through the heel of the injured foot (heel weight bearing) to start with.
Neighbour/buddy strapping
If your broken toe was strapped in the Emergency Department, you should have received a separate leaflet with advice on this. The strapping can be removed after 48 hours. You should then clean your foot and toes normally, and wear a well-fitting sock for support, for 4-6 weeks if needed.
Early movement of the ankle and foot is important to promote circulation and reduce the risk of developing a DVT (blood clot).
Exercises can help the healing process and ensure your ankle and foot do not become too stiff. You can repeat the gentle ankle and foot range-of-movement exercises provided in this information, as comfort allows, 3-4 times a day over the first 6 weeks following your injury. If you have increased pain or worsening symptoms, you should stop the exercise and seek further advice from your doctor.
Ankle and Foot Exercises
In a seated position, or when resting in bed, with your legs outstretched in front of you, make sure your heels are not in contact with any surface. Each exercise can be completed 5-10 times, as comfort allows.
1. Point your foot up and down within a comfortable range of movement.
2. Make circles with your foot in one direction and then change direction.
3. Heels together, move your feet apart and then back together.
4. When comfortable, you can gently bend and straighten your toes as pain allows.
Healing
Broken toes normally take about 6 weeks to heal. In some cases, pain and swelling can be ongoing for 3 months.
Smoking and regular non-steroidal anti-inflammatory drugs can delay healing. For advice on stopping smoking please refer to the following website www.
At 6-12 weeks
You can begin to resume normal, day-to-day activities but should be guided by any pain you experience. Heavy tasks and long walks may still cause some discomfort and swelling. You may return to non-impact exercises such as cycling at 6 weeks, and impact exercises from 12 weeks or earlier if comfortable.
If you are experiencing ongoing pain and swelling, or symptoms other than at the site of the original injury, please seek medical advice from your GP.
Please follow the advice in this information. If you have any questions or concerns please contact the Fracture Clinic Team for advice, using the contact details provided
UCLH Fracture Clinic Tel: 020 3447 5042
Switchboard: 020 3456 7890 extension: 75042
Address: Fracture Clinic, Trauma & Orthopaedics,
Surgical Specialties Division, Ground Floor Central,
250 Euston Road, London, NW1 2PG
Website: www.
Or visit NHS website: www.
Call 111 when you need medical help fast, but not if it is an emergency.
UCLH cannot accept responsibility for information provided by external organisations.