Left Pinky Toe Fracture: Healing and Treatment Options

Fracture of the left big toe?

Hello, doctor.
I apologize for the inconvenience, but my wife fell while moving heavy objects and landed on her left little toe.
An X-ray at the hospital revealed that she has a fracture in her left little toe.
The doctor advised her to rest at home without the need for a cast.
However, after a month, during a follow-up visit, another X-ray showed that the bone has not healed much.
Would using a cast help her heal faster? She still needs to walk to and from work every day; could this be the reason for the lack of healing? Thank you, doctor.
I have attached the X-ray images: the first one is from the initial examination, and the second one is from the follow-up after one month.

Mr. Chen, 20~29 year old female. Ask Date: 2023/01/27

Dr. Shen Boquan reply Orthopedics

Hello, if you have a toe injury with a fracture, it typically takes about three months for the fracture to heal.
An X-ray taken after one month may not necessarily show the formation of callus; it mainly checks for any misalignment.
Applying a cast may help with faster healing, but it can be inconvenient for you.
Some people find discomfort with ointments or adhesive bandages, but rest usually leads to improvement.
If you are experiencing significant pain, taking anti-inflammatory and pain relief medication can provide better relief.
Wishing you good health.
Best regards, Shen Boquan.

Reply Date: 2023/01/27

More Info

When it comes to a left pinky toe fracture, the healing process and treatment options can vary significantly based on the severity of the fracture and the patient's activity level during recovery. In your wife's case, it appears that the initial assessment did not warrant the use of a cast, which is common for certain types of toe fractures, especially if they are stable and not displaced. However, the fact that there has been little to no healing after a month suggests that the fracture may require more supportive treatment.

Healing Process
Typically, a toe fracture can take about 4 to 6 weeks to heal, depending on various factors such as the type of fracture, the patient's overall health, and adherence to rest and care instructions. In your wife's situation, the lack of healing after a month indicates that she may not be allowing enough time for the fracture to heal properly. Walking and putting weight on the injured toe can impede the healing process, especially if the fracture is not stable.

Treatment Options
1. Rest and Immobilization: If the fracture is not healing, one of the first recommendations would be to minimize weight-bearing activities. This may involve using crutches or a walking boot to keep weight off the toe while it heals.
2. Casting: If the fracture is determined to be unstable or if there is significant pain and swelling, a cast may be necessary. A cast can provide the immobilization needed to promote healing and prevent further injury.
3. Buddy Taping: In some cases, especially for minor fractures, doctors may recommend buddy taping the injured toe to the adjacent toe. This can provide some stability and support while allowing for some movement.

4. Pain Management: Over-the-counter pain relievers such as acetaminophen or ibuprofen can help manage pain and reduce inflammation. However, it’s essential to follow the advice of a healthcare provider regarding medication, especially if there are any allergies or contraindications.

5. Follow-Up Care: Regular follow-up appointments are crucial to monitor the healing process through X-rays. If there is no improvement, further interventions may be necessary, including potential surgical options if the fracture is displaced or non-union occurs.

Lifestyle Considerations
Given that your wife needs to walk to work, it is vital to find a balance between mobility and healing. If she continues to walk on the injured toe, it could lead to complications such as chronic pain or deformity. It may be beneficial to discuss with her employer about temporary accommodations, such as working from home or adjusting her duties to minimize walking.

Conclusion
In summary, while a pinky toe fracture can often heal without a cast, the lack of healing in your wife's case suggests that further intervention may be necessary. It would be wise to consult with her healthcare provider about the possibility of using a cast or other supportive measures to ensure proper healing. Additionally, minimizing weight on the injured toe and following up with regular X-rays will be crucial in her recovery process. If she continues to experience pain or if the fracture does not show signs of healing, further evaluation and treatment options should be considered.

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