Toe and Forefoot Fractures

The majority of fractures that occur in the foot can be treated without surgery unless the fracture is significantly displaced and unstable.

Toe and Forefoot Fractures

The foot is comprised of many bones; the forefoot alone has 29 – 5 metatarsal bones and 14 phalanges (toe bones). A break in any of these bones can be very painful and make walking a difficult task. An x-ray is used to evaluate the injury and determine the location, type and severity of the fracture. Fractures of the toe (phalangeal bones) are the most likely bones of the foot to fracture. Toe fractures, while painful, often do not need any surgical treatment. Allowing the fracture to heal with rest, ice, elevation and supportive shoes are usually appropriate first-line care for most toe fractures. “Buddy-taping” the fractured toe to a neighboring toe can also help support the fracture while it’s healing. If the fracture is very displaced, your doctor may “reduce” or manipulate the fracture to realign the bone back to its proper anatomic alignment. This can be done under a local anesthetic. Metatarsal fractures are breaks in the long bones found in the middle of the foot. Like toe fractures, surgery is not often required and can be treated with a period of rest, ice, elevation and supportive shoe wear or a brace. Your doctor will monitor the fracture closely with serial x-rays during your treatment course to ensure proper alignment of the bone is maintained throughout the healing process. However, if there are several metatarsal fractures involved, concurrent ligamentous injury, and the foot is deformed or unstable, an open reduction with internal fixation (ORIF) with plates and/or screws may be necessary to regain proper function and mobility of the foot. This operation is done in a hospital under anesthesia. Your surgeon will identify which bones and ligaments need repair and will then use hardware and strong sutures to ensure that the injury is completely repaired and stable. The foot will be immobilized immediately after surgery in either a splint or a CAM boot. This post-operative protocol requires a period of non-weight bearing on the operative foot, followed by a gradual increase in weight restrictions and physical therapy exercises. Your surgeon and physical therapist will tailor your post-operative course to fit your specific surgery, ability and needs.

Left: Jones fracture; Right: ORIF of Jones fracture with a compression screw

DRUJ Instability/Arthritis, Ulnocarpal Impaction, DIP Pinning for Mallet Finger


The orthopedic surgeons here are also specially trained in the field of hand and wrist surgery and treat all conditions, from very straightforward to the most complex. Furthermore, we believe that even the simplest problems of the hand and wrist deserve evaluation from a hand specialist who has an expertise in understanding of the intricate anatomy of the hand.

Every Patient Matters

Every patient receives an in-depth consultation to devise a treatment plan that is right for their problem. Our specialists prefer non-operative and non-invasive treatments whenever possible, including physical therapy, medications, and/or injections. When we require surgery, we will then use minimally invasive surgical techniques to fix your problem, whether it is fixing a broken bone or repairing a tendon. Our goal is always to get you back to living your life normally as soon as possible.

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Please call us at 973-898-5999.