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Hallux (Big Toe) Fractures

Updated: Jan 26

In this blog post Cypress foot and ankle specialist Dr. Christopher Correa discusses the ins and outs of hallux fractures including conservative and surgical treatments.

The hallux, or big toe, is the largest and strongest toe of the foot and plays an important role in maintaining balance and propulsion during walking and running. The hallux consists of two small bones called phalanges. In contrast, the lesser toes (second through fifth toes) are smaller and more delicate than the hallux, and each consists of three phalanges. The lesser toes are connected to the foot by smaller joints called proximal interphalangeal (PIP) joints and distal interphalangeal (DIP) joints. While both the hallux and the lesser toes are important parts of the foot, the hallux plays a unique and critical role in maintaining proper foot mechanics and stability.

The most common way that a hallux is fractured is through a direct injury, such as stubbing the toe or dropping a heavy object on it. This can cause the bone to break, and may result in symptoms such as pain, swelling, bruising, and difficulty walking or bearing weight on the affected foot. In some cases, a hallux fracture may also occur as a result of an indirect injury, such as twisting or bending the toe forcefully. This type of injury can cause the bone to break or become displaced and may also lead to other complications such as ligament or tendon damage.

Symptoms of Big Toe Fracture

While hallux fractures and lesser toe fractures are both “toe” fractures the symptoms and treatment do have their differences. Symptoms of a hallux fracture can include pain, swelling, bruising, and difficulty bearing weight on the affected foot. In more severe cases, the toe may appear deformed or misaligned, and there may be an open wound or bone protruding through the skin. Since the hallux has so much more force moving through it compared to the lesser toes the pain with big toe fractures tends to be more severe than the lesser toes. In many cases patients with hallux fractures are unable to walk or even bear weight on the front part of their foot. Fractures of the hallux can occur as the result of a traumatic injury or as a stress fracture due to overuse.

Treatment of Big Toe Fractures

Minor nondisplaced hallux fractures can be successfully treated conservatively. Such treatments may include protect, rest, ice, compression, and elevation (known as P.R.I.C.E. therapy) to reduce swelling and pain, and the use of a protective splint or boot to immobilize the toe and prevent further injury. In more severe cases, surgery may be necessary to realign the bones and stabilize the fracture. Situations where foot surgery may be indicated for a hallux facture are:

  1. Displaced fracture: If the broken ends of the bone are not properly aligned, surgery may be needed to realign the bones and hold them in place with screws, pins, or plates.

  2. Open fracture: If the bone has broken through the skin, surgery may be needed to clean the wound and repair the bone.

  3. Comminuted fracture: If the bone is broken into multiple pieces, surgery may be needed to remove any small bone fragments and stabilize the remaining pieces.

  4. Non-healing fracture: If the bone fails to heal properly or there is delayed healing, surgery may be necessary to stimulate bone growth and promote healing.

  5. Fracture with joint involvement: If the fracture extends into the joint, surgery may be needed to restore joint alignment and prevent arthritis.

Ultimately X rays and an evaluation by a foot and ankle specialist is required to know where surgery is needed. If you recently suffered a hallux injury, make an appointment with the experts at Select Foot and Ankle Specialists today and take the first step towards recovery!

Big toe fractures, Hallux fractures

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