Fracture of the big toe: first signs, treatment, rehabilitation and consequences
A fracture is a violation of the integrity of the skeleton bone under the influence of a force that exceeds the resistance limit of the bone in question. Fractures of all kinds in the world of diseases are in third place.
Quite often in the practice of traumatologists, you can find a fracture of the big toe. According to statistics, such injuries are observed in 3-5% of all fractures and make up a third of free lower limb fractures.
What are the causes of injuries toes?
According to the cause of the fracture, they can be divided into two small groups. The first group includes traumatic ones that occur on healthy bones. And the second group includes the so-called pathological fractures that develop on the bone, which is weakened by osteoporosis, tuberculosis or metastasis of a cancerous tumor.According to statistics, approximately 95% of fractures are injuries, and the remaining 5% are fractures of a pathological origin.
There are many classifications of fractures, but the value of a clinical nature acquire only a few.
Open and closed fractures
According to the division of the big toe fractures by the presence of damaged skin of the skin with bone fragments, it is possible to distinguish: an open fracture and a closed fracture.
Due to the relatively high mobility and flexibility of the fingers, a large number of injuries form closed fractures. In this case, this type of fracture is well treatable, since for closed fractures it is not so often necessary to resort to surgical intervention, and, accordingly, it is possible to avoid the additional risks associated with the fracture.
If your toe hurts, it can talk about a fracture.
With and without offset
Fractures with displacement and fractures without displacement are also isolated. The smallest complexity is caused by fractures without displacement of bone fragments, since they do not require the formation of fragments in their physiologically correct position.A fracture with displaced fragments is considered an open fracture, based on the fact that without displacement, the formation of pointed bony edges ruptured the skin is excluded.
What are the symptoms to determine the fracture of the big toe?
Having determined the presence of a fracture, we can say that the centuries have fulfilled the most important stage in the provision of first aid, which is present in the curriculum of many general and specialized educational institutions. The presence of knowledge and the ability to put into practice the ability to recognize a fracture can often help to avoid the severe complications associated with unprofessional primary care actions if a toe is sore.
The symptoms that determine a fracture of a finger are the same as for fractures of other localizations. To more accurately determine the presence of such an injury, the symptoms are divided into two categories - reliable and probable. The likely include: pain at the fracture site; the presence of redness at a possible fracture site; swelling of soft tissue; unnatural finger position; the occurrence of acute pain at the fracture site; increased tissue temperature at the site of the fracture; the inability to arbitrarily move a finger. To verify the correctness of the diagnosis will help X-ray of the foot.
Significant signs of a fracture include: a bone defect is observed when feeling the bone; abnormal bone mobility; noticeable bone deformity; shortening of a broken finger may be observed; crepitus of bone fragments.
Signs defining a fracture of a finger
Often, a toe injury proceeds without a pronounced clinic, especially during a fracture that does not result in a displacement or a small crack. In this situation, the patient often does not pay attention to it. In addition, patients simply do not want to consult a doctor and conduct research to establish an accurate diagnosis.
Important in the diagnosis of big toe fractures is given to radiography of the foot in one or two projections. Thanks to this paraclinical study with an accuracy of 95-99%, it is possible to recognize whether there is an injury to the toe, determining the location of the fracture and the location of the bone fragments with an accuracy of up to a millimeter.
First aid in obtaining this injury is extremely necessary. First, to perform anesthesia, as it will reduce the discomfort that occurred during the injury, and allow you to perform further actions with your finger. Secondly, it is necessary to disinfect the wound, if any.Third, immobilize the fracture.
In case of a fracture, it is recommended to contact an ambulance as soon as possible.
When do they put plaster on the big toe?
Finger fracture treatment
Methods for treating fractures of the toes are not fundamentally different from methods for treating fractures of the fingers, due to the similarity of their anatomical structure. Depending on what type of fracture, and whether there are associated complications, use a certain type of treatment. Currently, there are three approaches to the treatment of this injury: single-stage closed reposition; skeletal traction; open reduction. We characterize each of them.
One-time closed reposition is used for fractures of closed toes, accompanied by displacement of bone fragments. The essence of the method is anesthesia of the fracture site and the subsequent smooth stretching of the finger with the simultaneous formation of bone fragments in their physiological position.
It controls the x-ray of the foot.
Skeletal traction is used in case of failure of simultaneous reposition, or, in other words, in the case when the combined bone fragments can not be kept in the correct position after numerous attempts at their reduction.The essence of the method is to maintain the distal fragment in the position of retraction, so that the pressure on the damaged phalanx is reduced, as well as the prevention of the recurrence of the fragments.
Open reduction - is a holistic operation in which the process of connecting parts of the bone occurs and its correct shape is restored. The essence of the method is its use in all possible open-type fractures, closed-type multiple fractures and complications that have arisen after previous methods of reposition.
Treatment for a fracture of the big toe should be timely.
Can there be complications?
Many patients who have suffered a similar trauma do not often seek medical help, because they do not consider a fracture a significant injury, and thereby delay the moment of successful wound healing. Often it goes without any problems, but sometimes there are complications that bring the patient great inconvenience and experience, more than the fracture itself. The most common ones encountered in this type of injury are: false joint; vicious union; osteomyelitis; large callus; ankylosis; gangrene and othersWe characterize each species in more detail.
Callus is the physiological growth of bone tissue in the place where the fracture occurred. The magnitude of callus after a fracture often depends on qualitatively correlated fragments. In addition, this bone formation can be a source of persistent inflammation and pain that occurs when pressure changes in the atmosphere.
A false joint is characteristic of an untreated finger fracture when bone fragments are displaced. If the fracture is not set during the initial period of time, the canals of the bone fragments are usually closed. The edges of the bones as a result of continuous friction against each other begin to fade and rounded. As a result, after a certain period of time, instead of one solid bone, two begin to form, which are not interconnected. In addition, the continuous contact of the bones, forming a false joint, does not entail the formation of cartilage, which reduces friction, and as a result the false joint is in continuous inflammation, which develops into chronic and accompanied by periodic exacerbations.
Ankylosis often occurs just at the turn of the toes. This is explained by the fact that the phalanx of the finger has a small length and forms three joints on a small part of the body, such as a finger. Thus, it can be assumed that if there is a fracture of the toe, not one bone and not one joint will be affected. When the joints become inflamed, they harden and, as a result, ossification occurs. At the end of this process, instead of two or three bones located in the neighborhood, one solid bone begins to form, having massive bone callosities. Based on this, the degree of mobility of the limbs is reduced due to a decrease in the number of functioning joints. Unfortunately, there is currently no effective treatment for this type of complication.
So, if your toe turned blue, you should immediately consult a doctor.
Abnormal adhesion of the bone occurs in the absence of the necessary treatment for a fracture of any nature that has an offset. Improper location of the bone fragments or the lack of it during the splicing of the bone can lead to improper healing.As a result, a large callus, pathological curvature of the bone can form, and it shortens. As a result, there is a violation of its support function. And there is a possibility that at any pressure the bone is likely to break again.
With a big toe injury there may be other complications.
Osteomyelitis is an inflammation of the bone marrow. It is primary hematogenous and secondary traumatic. At the first, pathogenic bacteria get into the bone marrow canal by transferring blood from another existing source of infection in the body. In another type of osteomyelitis, these bacteria can get into the bone as a result of direct contact with dirty objects. Thus, osteomyelitis of the toe quite often can develop solely with open fractures, when not only the big toe has swollen, but the skin has ruptured.
An open fracture must be treated properly. For this it is important to carefully treat the wound. During the treatment of wounds with antiseptics, the risk of secondary osteomyelitis can be reduced several times.And, of course, the lack of initial treatment, in the case when the patient does not go to the hospital, can create prerequisites for osteomyelitis.
Gangrene is the death of a certain type of human tissue. After receiving a fracture of the nail phalanx of the big toe, gangrene can develop gradually, starting right after the stroke. The algorithm of its development is as follows: a sharp compression of a tissue site and its subsequent oxygen deprivation, the cause of which is a violation of the blood circulation of the damaged area. In younger people who have not resorted to proper treatment, gangrene often does not border on healthy tissues and is separated on its own. But if it gets into the tissue, which is in the stage of withering away of pathogenic bacteria, suppuration begins, which can lead to the further spread of inflammation to the entire limb. In people of advanced age and in people suffering from vascular diseases, gangrene often does not separate itself and gradually progresses. If you do not have the necessary surgery,this can lead to an increase in dead tissue, and as a result to disability.
The rehabilitation period after the fracture of the big toe
The symptoms of the injury we reviewed.
The recovery period after surgery often depends on the level of complexity of the fracture, the age of the patient, the disease and the existing purulent complications.
The operation to reposition the bone fragments at an open fracture that has an offset is considered relatively uncomplicated, thus, after it, a rather short recovery period is 3-4. If the fracture is comminuted, then the average recovery period may increase by 2 weeks.
Wounds with purulent complications imply their re-opening and even the removal of dead tissue. In this case, the recovery period is usually doubled. The fastest rate of bone regeneration can be observed in children and adolescents. From about 40 years each year, the rate of regeneration begins to decline, and so on until old age.