Toe and Metatarsal Fractures (Broken Toes)
- Each foot has 26 bones
- There are more than 100 ligaments in each foot
- Diabetes is the #1 cause for lower extremety amputation
- A toenail takes 4-9 months to completely grow out
- Pain in the feet is NOT normal
Surgery: YES OR NO????
- Deciding whether or not to have surgery is a big decision.
- Our foot and ankle surgeons are skilled in both surgical and conservative options.
- We will present the options most suitable for you and help you with your decision.
How much pain should I be in before I make an appointment?
- Foot pain is not normal.
- Foot pain is a signal that something is not right.
- Any degree of foot pain warrants an evaluation to determine the source of the pain and possible treatment options.
- Most foot pain left untreated will get worse and become more difficult to cure.
- If you have foot or ankle pain, make an appointment, do not wait.
Will soaking cure my ingrown toenail?
- Soaking an ingrown toenail will often make it feel better, but it will not cure it.
- The symptoms of an ingrown toenail include pain, redness, and swelling.
- An ingrown toenail is easily cured with a simple in office surgical procedure.
- The toe is anesthetized so that pain is not felt during the procedure.
- The ingrown nail, or portion of the nail, is removed.
- Most people feel no pain afterwards and return to normal activities the next day.
What are orthotics?
- Custom made foot arch supports designed to hold the foot in its optimum position
- Can alleviate the discomfort caused by a number of foot conditions such as heel pain, bunions, and flat feet.
Happy Feet...Happy Bride
Comfortable footwear can help make the perfect day even better. Many times foot or ankle discomfort can be alleviated with appropriate shoes. It is not unusual for people to buy shoes that are too small for their feet. If your foot problem has an easy solution, our podiatrists will gladly provide you with that information. Sometimes the right shoe is not enough and custom-made orthotics is necessary to help the feet maintain the best position. Our podiatrists can utilize a three dimensional digital scan to have custom made inserts (orthotics) fabricated for your shoes, made from the scan of your feet to correct your specific foot abnormality and fit your feet only. If your foot or ankle problem can be resolved with conservative treatment, our podiatrists will advise you of the best treatment for you. There are times when the best solution for a foot or ankle problem is surgery. If you require foot or ankle surgery, our podiatrists can provide you with the latest state of the art surgical techniques. They will take the time to explain to you what to expect before, during and after surgery and will try to answer all your questions. Whatever your foot or ankle problem may be, our podiatrists will explain the various treatment options available to you. Everyone is happier when their feet are happy!
Thoughts on Celebrating 30+ Years
Some thoughts from Dr. Jacoby:
On April 30, 1984 I took over this podiatry practice. Elgin became my professional home as well as my personal home. I am forever grateful to Dr. Roger Hess who started this practice 50 years prior. Dr. Hess was a gentleman whom I admired and emulated both professionally and personally. I am forever honored to continue caring for the patients who initially trusted Dr. Hess.
My first office was at 860 Summit on the East Side of Elgin. I remember painting the office myself. I moved twice into larger space at 860 Summit. Eventually we outgrew the space there and moved to larger space at the Sherman Hospital Medical Building and then finally here to 750 Fletcher. I am grateful to the multitude of patients we have had the privilege of treating and that have kept us growing. I am also grateful to the multitude of other physicians in the area whom I am so privileged to work with.
Not only has this practice grown in physical space, but we have grown technologically as we offer many state of the art alternatives. My staff has been and continues to be essential. To all my staff, both past and present, I say a most sincere Thank You.
I look back on the years with much pride and sentimentality. I look forward to the future with the same enthusiasm and joy I felt on April 30, 1984. I love what I do and every day I realize how blessed I am to be in this wonderful profession!
The structure of the foot is complex, consisting of bones, muscles, tendons, and other soft tissues. Of the 26 bones in the foot, 19 are toe bones (phalanges) and metatarsal bones (the long bones in the midfoot). Fractures of the toe and metatarsal bones are common and require evaluation by a specialist. A foot and ankle surgeon should be seen for proper diagnosis and treatment, even if initial treatment has been received in an emergency room.
What Is a Fracture?
A fracture is a break in the bone. Fractures can be divided into two categories: traumatic fractures and stress fractures.
Traumatic fractures (also called acute fractures) are caused by a direct blow or impact, such as seriously stubbing your toe. Traumatic fractures can be displaced or non-displaced. If the fracture is displaced, the bone is broken in such a way that it has changed in position (dislocated).
Signs and symptoms of a traumatic fracture include:
- You may hear a sound at the time of the break.
- “Pinpoint pain” (pain at the place of impact) at the time the fracture occurs and perhaps for a few hours later, but often the pain goes away after several hours.
- Crooked or abnormal appearance of the toe.
- Bruising and swelling the next day.
- It is not true that “if you can walk on it, it’s not broken.” Evaluation by a foot and ankle surgeon is always recommended.
Stress fractures are tiny, hairline breaks that are usually caused by repetitive stress. Stress fractures often afflict athletes who, for example, too rapidly increase their running mileage. They can also be caused by an abnormal foot structure, deformities, or osteoporosis. Improper footwear may also lead to stress fractures. Stress fractures should not be ignored. They require proper medical attention to heal correctly.
Symptoms of stress fractures include:
- Pain with or after normal activity
- Pain that goes away when resting and then returns when standing or during activity
- “Pinpoint pain” (pain at the site of the fracture) when touched
- Swelling, but no bruising
Consequences of Improper Treatment
Some people say that “the doctor can’t do anything for a broken bone in the foot.” This is usually not true. In fact, if a fractured toe or metatarsal bone is not treated correctly, serious complications may develop. For example:
- A deformity in the bony architecture which may limit the ability to move the foot or cause difficulty in fitting shoes
- Arthritis, which may be caused by a fracture in a joint (the juncture where two bones meet), or may be a result of angular deformities that develop when a displaced fracture is severe or hasn’t been properly corrected
- Chronic pain and deformity
- Non-union, or failure to heal, can lead to subsequent surgery or chronic pain.
Treatment of Toe Fractures
Fractures of the toe bones are almost always traumatic fractures. Treatment for traumatic fractures depends on the break itself and may include these options:
- Rest. Sometimes rest is all that is needed to treat a traumatic fracture of the toe.
- Splinting. The toe may be fitted with a splint to keep it in a fixed position.
- Rigid or stiff-soled shoe. Wearing a stiff-soled shoe protects the toe and helps keep it properly positioned.
- “Buddy taping” the fractured toe to another toe is sometimes appropriate, but in other cases it may be harmful.
- Surgery. If the break is badly displaced or if the joint is affected, surgery may be necessary. Surgery often involves the use of fixation devices, such as pins.
Treatment of Metatarsal Fractures
Breaks in the metatarsal bones may be either stress or traumatic fractures. Certain kinds of fractures of the metatarsal bones present unique challenges.
For example, sometimes a fracture of the first metatarsal bone (behind the big toe) can lead to arthritis. Since the big toe is used so frequently and bears more weight than other toes, arthritis in that area can make it painful to walk, bend, or even stand.
Another type of break, called a Jones fracture, occurs at the base of the fifth metatarsal bone (behind the little toe). It is often misdiagnosed as an ankle sprain, and misdiagnosis can have serious consequences since sprains and fractures require different treatments. Your foot and ankle surgeon is an expert in correctly identifying these conditions as well as other problems of the foot.
Treatment of metatarsal fractures depends on the type and extent of the fracture, and may include:
- Rest. Sometimes rest is the only treatment needed to promote healing of a stress or traumatic fracture of a metatarsal bone.
- Avoid the offending activity. Because stress fractures result from repetitive stress, it is important to avoid the activity that led to the fracture. Crutches or a wheelchair are sometimes required to offload weight from the foot to give it time to heal.
- Immobilization, casting, or rigid shoe. A stiff-soled shoe or other form of immobilization may be used to protect the fractured bone while it is healing.
- Surgery. Some traumatic fractures of the metatarsal bones require surgery, especially if the break is badly displaced.
- Follow-up care. Your foot and ankle surgeon will provide instructions for care following surgical or non-surgical treatment. Physical therapy, exercises and rehabilitation may be included in a schedule for return to normal activities.
For more information on broken toes, listen to the Broken Toes podcast.