This little piggie went OWWWW all the way home
October 30, 2008 6:19 AM   Subscribe

I think I broke my littlest toe. Everything I read online says that basically nothing can be done, so there's no point in going to the doctor, right?

This happened about 24 hours ago. It's swollen, bruised, and painful. I buddy-taped it overnight, but it seemed to make it MORE painful this morning. I can handle pain just fine and I have strong (legal) painkillers available if I need them. My life is very sedentary so it will get a lot of rest. My husband is concerned about longer-term complications (he mentioned gangrene, is he full of crap?). This is all his fault anyway because he left the thing on the floor that I walked into.

So, should I see a doctor, should I DTMFA, and do I need a lawyer? :)
posted by desjardins to Health & Fitness (26 answers total)
You should DTMFA. :)

But I just saw something online that says their doctor popped their pinkie toe (which was dislocated and broken) back into place, so, sorry, but you should probably see a doctor. :)
posted by nitsuj at 6:26 AM on October 30, 2008

2nd seeing a doc. It might need to be re-aligned properly before it's buddy-taped for healing. When I broke my pinky toe it was at a right angle to the others so there was no question. But all the ER doc did was put a ballpoint pen between the pinky and the next toe (for leverage) and pop it back into place before taping. I was told to keep it elevated for a few days. If I were you I'd go to an urgent care clinic, if for nothing else than you want xrays to make sure you don't have a hairline fracture nearby that might complicate things.

I'm speaking as someone who's sitting at home right now recuperating from a broken leg. Even though it was obvious where the break was when it happened, they also took xrays of the knee and ankle to check for other fractures, and sure enough, I have one in my ankle.
posted by ImproviseOrDie at 6:38 AM on October 30, 2008

IANAD, etc.

I've broken toes a few times and never been to the doctor for it...usually it takes maybe a week to get back to bearable status and a few to heal completely. Really the thing that's going to cause a lot of pain is the that end, I've found that this treatment works pretty well to minimize discomfort:

1) Elevate it above your heart. Pillow on the sofa armrest works great.
2) Ice it every few hours. Hubby's assistance may prove helpful here.
3) Ibuprofen as directed on the bottle. Legal painkillers will be helpful, but Ibuprofen will help reduce the inflammation and swelling, which are what's really hurting.

If it doesn't start looking better in a few days, or the swelling/bruising goes down and it Just Doesn't Look Right, you'd definitely want to see a doctor. Otherwise, this is one of those routine injuries for which time is the best remedy.
posted by baphomet at 6:39 AM on October 30, 2008

When my sister broke her pinkie toe, the Doctor just taped it to the next toe over and told her to take Tylenol for the pain. It might be worth to visit just to ensure that you have a break and not a dislocation, but they won't put a splint on it or anything.
posted by WinnipegDragon at 6:39 AM on October 30, 2008

I vote for seeing a doctor, because I broke a toe once, didn't see a doctor, and now it's all crooked and sometimes hurts. When I (finally, years later) asked a doctor about it, he said that it could have been easily straightened at the time, but to straighten it now would mean rebreaking it and maybe surgery, too, and might not even stop it from hurting.

So, seeing a doctor now is better than perhaps needing to see a doctor later, though gangrene is unlikely.
posted by Forktine at 6:39 AM on October 30, 2008 [1 favorite]

Sorry to hear that buddy-taping it made it worse; when I broke my baby toe that made it feel much, much better. Mine was a minor break which leads me to surmise that perhaps yours is a slightly more serious break. That's a total guess, though, and in all honesty I would probably not see a doctor.

For the record I also think the gangrene is just not going to happen.
posted by kate blank at 6:39 AM on October 30, 2008

Yeah, you want to see the doctor to make sure there's nothing else wrong in addition to the stuff they can't do anything about.
posted by winston at 6:40 AM on October 30, 2008

I had trauma to my little toe six months ago. Now it has gout. Just saying.
posted by wackybrit at 6:47 AM on October 30, 2008

IANAD, but my parents are and I have broken toes quite a few times. My pinkie toes are the frequent victims of my clumsiness. They always just say "tough it out" because they aren't going to be able to do anything and it generally just sorta heal up on its own.

If you're super concerned, then go if only for your peace of mind, but I would wager there is nothing to be done.

also, I would be SHOCKED if anyone got gangrene from a broken pinkie toe. LOL
posted by gwenlister at 6:48 AM on October 30, 2008

I am advising from the point of very limited personal experience combined with the experience of someone I once knew who did a lot of backpacking throughout parts of Asia, and thus has a lot of experience with foot woes and first aid.

I'm pretty sure I cracked a bone on my big toe once (handy tip -- never drop a fencing rapier point-down directly onto your toe from a height of four feet), but I never went to the doctor; I just taped it to the toe beside it and went easy on it for a couple weeks. A couple days after it happened I did call my friend, who confirmed that yeah, I was probably doing the right thing - nothing was sticking out, my toe wasn't misaligned or visibly a different shape; it was just bruised and hurt. "If that's all it is, your doctor would just tape it to the toe next to it, like you're doing," he said. In fact, the only reason I'm pretty sure it was a hairline crack as opposed to just a bruise was that the bruising stayed for a couple weeks instead of fading after a couple days, and I've read that bruising of that duration is a sign that there was at least a hairline crack.

But -- I hadn't gotten my injury from bending it funny or anything like that, I just dropped something heavy on it. So as far as fractures go it was pretty low-impact. It healed fine, too. It sounds like you stubbed your toe pretty good - is that what happened? I may have also had a slight fracture that same way as well, but that bruising started fading after one week, so I don't know what to make of that.

I do strongly doubt gangrene would be a factor, and you probably don't need to go to the hospital and get this checked out. (The increase in pain may simply be because you made the bandage too tight -- also, did you put ice on it at all? If not, I'd definitely advise that, to bring down swelling.)

But -- the devious side of me thinks that if your husband is fretting, and since he left the thing you got hurt on in the middle of the floor anyway, this is an opportunity to really milk it and let him squire you to the doctor and fret over you and spoil you a little to "Make up for it." You'll probably be fine if you don't, but hey, let him wonder. ;-)
posted by EmpressCallipygos at 6:49 AM on October 30, 2008

Response by poster: The main reason I don't want to go to the doctor is time, not money. I have excellent insurance. I don't have any time in the next few days unless I break some serious commitments. I've already broken said commitment once for medical reasons and I'm loathe to reschedule it again (plus I'll probably lose hundreds of dollars if I do). After work tonight I have to prepare for said serious commitment, and I have no time off left at work due to previous medical issues. So, if y'all convince me it's serious, I'll bite the bullet and go to the doctor, but otherwise if it's just going to be a pain thing, no problem, I can deal.
posted by desjardins at 7:02 AM on October 30, 2008

Best answer: I made a post a long time ago to someone who broke something. I realize me telling you to look it up probably isn't helpful, but it's my best "EMT Answer" to the question.

You really should have some traction pulled on it, although after 24 hours that's going to hurt hella worse than if you had done it 5 mins after you did it. Theoretically some very nasty things can happen if you don't "set" it, but those chances are slim. A badly healed break can, however, cause long term pain and disfigurement. Although, realistically, buddy taping it to the adjacent toe will, quite likely, force-set it on its own.

Tylenol or Naproxen (Aleve), ice, buddy tape.

And yea, learning how to relocate joints and set fractures on your own in the field makes you hardcore as hell. "Dude look at your finger!" "Pop!"

Here's a secret trick: a break hurts as point specific pain. Like, you can point to it. A sprain/strain/dislocation tends to hurt in an area. It's fairly likely you dislocated it and the buddy tape DIDN'T relocate it, and now you've got associated trauma from it rubbing around its socket all night.
posted by TomMelee at 7:06 AM on October 30, 2008 [1 favorite]

When I had a badly broken big toe (confirmed by my doctor, natch) the one thing that really helped alleviate the pain was wearing a sturdy, form-fitting shoe.

It compressed the toe, helping keep the swelling in check, and also kept the toe from having to flex or bear much weight. I didn't want that shoe off for even five minutes that first week.
posted by OilPull at 7:09 AM on October 30, 2008

Seconding the importance of the right shoes while your toe heals. If you have to walk, wear some really sturdy shoes that do not allow the broken toe to bend with each step you take. When I broke a bone in my foot (behind the pinky toe) the doctors gave me a special shoe-type thing that was easy to strap on to my swollen foot and did not allow any bending. Hiking boots were also good, once the swelling had gone down a bit. I had a lot of pain for about four weeks, but that was probably due to needing to walk on it a lot every day. Good luck!
posted by beandip at 7:33 AM on October 30, 2008 [1 favorite]

I've just gotten over a broken middle toe. A friend who's an orthopedic surgeon took a look at it and said, 'yep, you crunched it.' He had me tape it to an adjacent toe and that was that. HOWEVER, in the course of the discussion he mentioned that toes towards the middle of the foot are less troublesome because they are less critical to walking. He said he'd have been more concerned if it were a big toe or littlest toe. So while I think you'd probably be fine treating this yourself, you are dealing with an important toe and the risk may not be worth it.
posted by jon1270 at 7:33 AM on October 30, 2008

I am a total hypochondriac and this falls well within my "wait and see" category. Then again I've stubbed it so hard I've broken it more than once and my feet still work fine, so maybe I am just bouyed by incredible good luck.
posted by dame at 7:37 AM on October 30, 2008

For what it's worth, my college-soph daughter broke her little toe in August. Playing Ulitimate Frisbee in a beach tournament ... she landed and a guy landed right on her toe ... snapped it in half almost. Went to doc and he set it back into place. Then it was tape and ice. Worked well enough that she was back diving for her college team by October 1. In short, definitely see a doctor to have it placed right, but then the healing seems go pretty fast and involve not much more than tape and a week or so of a weird boot.
posted by lpsguy at 8:08 AM on October 30, 2008

I've broken my pinkie toe twice. To make the taping feel a little better, make sure you put a decent amount of gauze or cotton between the two toes, but only enough so that your broken toe is in its natural position. Taping will intensify the pain a little bit, but after a few days you'll be glad that you have it.
posted by nikkorizz at 8:19 AM on October 30, 2008

Unlikely, but my uncle is missing a toe. He broke it, skipped the doc and it went, I think, gangrene. Or gout. Or infection. In forget, but the end result is that he's down a toe. So, hit the doc it looks to be getting worse.
posted by GilloD at 8:23 AM on October 30, 2008

I've broken two toes. The first time, due to the scary swelling of my entire foot, I went to a doc, who basically couldn't do much other than give me codeine and one of those bootie things that was too uncomfortable to wear.

The second time, I just taped it to the neighboring toe and hoped for the best. After a couple days of pain and rest, the swelling went down, I was able to wear shoes again, and all was well.

I think it all depends on your comfort level.
posted by chez shoes at 8:45 AM on October 30, 2008

I am not a doctor, but I do break toes all the time. (I play Judo on wrestling mats, which is a bad combination). The first time I broke a toe, I went all nuts and went to Student Health, whereupon the doctor told me:

"Just buddy tape it, you have better tape than I do, ha ha, pigs don't even have that toe and they're fine."

I had excellent health insurance, so I went to Sports Medicine.

The doctor took an x-ray and told me:

"Just buddy tape it, ha ha, pigs don't even have that toe and they're fine."

Then I had to pay someone $100.

If the swelling doesn't go down, you get any sort of smelly stuff or red streaks or the skin is crinkly to the touch and stuff, though, definitely go see a doctor.
posted by Comrade_robot at 9:13 AM on October 30, 2008

You should go see the doctor. Gangrene in this case is rare, but you have absolutely no way to tell whether there's blood flow being limited by the fractured bone.

Your chances of serious damage or worsening are pretty small, but they're not so small that they're worth making a bet on. 10 minutes with a competent orthopedist (or, really, even a first year resident in the ER with an xray or mri) can tell you whether you need to leave it until it heals, or if something needs to be done.

I hope the pain goes away soon. Ouch!
posted by Citrus at 10:04 AM on October 30, 2008

Response by poster: UPDATE

I went to the urgent care (Thanks TomMelee!). The X-ray showed no fractures or dislocation, so I was diagnosed with a contusion. They buddy-taped it and gave me some horrendously ugly shoe, so unless I get stopped by the fashion police, I'm good to go. I'm probably out a $50 copay and a couple hours of work, but it's a fair price to pay for peace of mind.
posted by desjardins at 10:51 AM on October 30, 2008

Fantastic. Glad to hear youz gonna be OK.

BTW broken toes suck. I've had abdominal surgery, torn my achilles, ripped apart my knee, dislocated my shoulder enough that I'm totally Bruce Willis in Die Hard now, and once I even snapped off a piece of cartilage in my rotator cuff and you could literally hear it grinding around as I moved my shoulder. I get shinsplints the size of walnuts. I knocked out 6 teeth on my bottom gum in a bicycle accident. I can dislocate my collarbone at will. I gave myself a 1.5% total body area partial thickness burn in a motorcyle accident, and all that being said...

When I broke my big toe landing funny after jumping for a light switch (what, I'm short, ok?) the pain from that was more frustrating and intense than any other ever. Well, that and athlete's foot drives me bananas, but that's because it's just irritating.

Glad to hear you're all patched up. :)
posted by TomMelee at 1:27 PM on October 30, 2008

I had the same injury as ImproviseorDie. This happened when I was 14, when I ran into a door in my house. It was my right foot, with the littlest toe pointing 90 degrees to the right. We went to the ER, sat around for a couple hours, and got X rays. The doctor set it (meaning he grabbed it and lined it up with my other toes--man, did that hurt!) and taped it. I hopped around with crutches for a few weeks, wearing a sneaker with the corresponding toe area cut out. No special boot. My mom promised that I would have a toe that could predict the weather, but she was wrong!

Glad to hear it wasn't broken. Heal quickly!
posted by computech_apolloniajames at 5:01 PM on October 30, 2008

Response by poster: 4 days later and I'm wearing normal shoes again. There's still intermittent pain, but definitely bearable. I don't walk around in the dark anymore, though.
posted by desjardins at 2:13 PM on November 3, 2008

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