Comminuted Toe Fracture

A fracture of the toe, especially a comminuted fracture can cause severe complications such as permanent deformation in the framework of toe bone, resulting in difficulty in movement, chronic pain and in severe case, arthritis. The human toe is made up of bones, also termed as phalanges. The big toe consists of proximal phalanges, at the bottom of the toe and distal phalanges, at the tip of the toe, while the other 4 toes consist of middle phalanges connecting distal phalanges and proximal phalanges.

There are different types of bone fractures such as, comminuted fracture, non displaced fracture, compressed fracture and displaced fracture. Comminuted fracture is the one which causes the bone to splinter into small fragments. Non displaced fracture causes the bone to break, however, it doesn't get displaced from its original position. Compressed bone fracture would cause the bone ends to get compressed towards center. Displaced fracture changes the normal position of the bone. Compound fracture would cause laceration of soft tissue and the bone would bulge out from skin. The toe fracture is usually caused in the proximity of the metatarsophalangeal joint, which is where the toe is joined to metatarsals, or mid foot bones.

Causes and Symptoms
If a heavy load falls on your foot crushing your toes, or you strike your toe accidentally on an object while walking, or sometimes due to a severe accident, it may result in comminuted toe fracture. If the injury is severe, causing fragmentation of the bone, it leads to such a fracture. The location of the toes make them more prone to injury of foot. Certain sports require continuous and repetitive movements of the foot making them more susceptible to fractures. It is also referred to as stress fracture. Symptoms include inflammation and discomfort, along with stiffness. If the big toe is fractured, the person finds it difficult and painful to walk, since big toe sustains more body weight while walking as compared to the other toes. A bruise may also be noticed around the injured area. If untreated, it can get permanently disfigured.

Diagnosis Methods
The diagnosis can be made by applying pressure on your toes to check if you experience any pain or discomfort. Another test includes keeping your foot stationary and moving the toes in different directions. If you have a fracture, you will experience acute pain. And the doctor can observe restricted motion of the injured toe, as compared to the other ones. Another test involves squeezing the toe tip. The physician looks for the time required for the toe tip to return to normal color due to blood filling back in toe tip. This is done to determine if you have blood circulation problems. If the deformation in the toe is visible, tests like X-ray are done in order to determine the severity of fracture in toe. X-ray reveals any deformation or internal injury such as crushing of the bones of toe.

Treatment
Treatment depends upon the severity of the injury. If the fracture is unstable, which means, your toe can't hold its normal position, the doctor may heal it with the process called internal fixation. It is defined as the surgical procedure in which an incision is made to join the bones and hold them together by metal rods, plates or wires. Depending on the severity, the injured toe needs to be splinted, in order to immobilize the fractured bone. In case of open wound, it becomes necessary to administer tetanus shot and antibiotics medication. In case of a compound fracture, surgery needs to be done and antibiotics, along with pain killers are prescribed. In case of a displacement fracture, where the broken bone gets displaced from the original position, closed reduction method can be used, wherein, the broken toe is taped with the next toe, to hold it onto the position. In this case, surgery is not required.

In case of any injury, seeking timely medical advise is the key to keep further complications at bay.