Sunday, April 8, 2012

So You Think a Broken Toe Isn't Serious?

So you think a broken toes is no big deal? Just last week I had a runner come in 6 months after breaking her 5th toe by kicking a shopping cart. She didn't have it x-rayed because in her words, "I didn't think there was anything you could do for a broken toe".

Here she was six months later because not only was she having a hard time fitting her still swollen toe in a high heeled shoe for work, but now it was bothering her in her running shoes. Pain when running will always bring a runner in the office!

What had happened is that she had an oblique fracture of her proximal phalanx which was displaced and healed in an abnormal position. In English, she broke her 5th toe and the bone healed crooked making a big lump that rubbed on her 4th toe causing a blister then a large corn in between the toes.

These types of corns known as "heloma molle" are very painful and can often get infected. In a diabetic or other patients with poor immune systems, these can even lead to a toe amputation! In my runner's case, she was treated conservatively with a silicone toe sleeve to pad it off until she had time to have an arthroplasty of the toe which is a surgery that removes part of the poorly healed bone and alleviates the rubbing. This surgery could have been prevented by seeking help earlier as soon as she broke her toe. 

Take home message: if you think you broke your toe, have it x-rayed and see your favorite podiatrist. They may tell you it is broken, but straight; or they may need to numb it up and pull it back into the correct position, so you can avoid surgery that will keep you laid up for weeks!