Toe Fracture or Dislocation

Toe Fracture or Dislocation

Following your recent visit to our Emergency Department/Minor Injury Unit it has been confirmed that you have sustained an injury to one or more of your toes which will heal naturally over the next few weeks and does not require any future hospital treatment or visits to our Fracture Clinic.

What to expect

Weeks since injury	Rehabilitation plan
0-3	Initially you should elevate your foot regularly to reduce swelling You can strap the affected toe to your adjacent toe for up to three weeks If it is more comfortable for you If supplied, wear the shoe or boot for comfort when walking but remove it for night and when resting If a boot/shoe was not supplied we recommend using a firm-soled shoe to avoid too much flexion of the foot when walking You can start moving that toe gently as much as pain allows
3-6	If you have been using it, try and stop using the boot/shoe. Start around the house first The swelling and bruising should naturally subside Continue exercises to that area to regain flexibility in your foot and ankle
6-12	The fracture/dislocation should be healed by now. You can have mild symptoms for 3-6 months You can resume normal day-to-day activities, but be guided by your pain Heavy tasks and long walks may still cause some discomfort and swelling
12	If you are still experiencing significant pain and swelling, please contact the Virtual Fracture Clinic for advice

Neighbour strapping:
Gauze should be placed between the two toes to prevent rubbing and any breakdown of the skin. Ideally, the padding should extend almost the full length of the shorter toe. Excluding the big toe, each toe has three joints (the places where your toe bends). Place one piece of tape over the toes in between knuckles. This allows the injured toe to flex and extend. If your toe starts changing colour, or you get pins and needles that wasn’t there before, then the strapping is too tight. Change the strapping daily to allow skin care.

Mobilizing:
We also recommend minimising the pressure exerted through the toes when walking by weight bearing through your heel bone rather than the toes. You may have been provided with a wedge shoe to help you do this. The pain will subside over a few weeks, and you should return to walking normally and fully bend your toes within six weeks.

Swelling & Pain
Part of the body’s normal response to injury is pain and swelling. Follow the simple steps below to manage your symptoms.

• Ice: Ice is a great natural anaesthetic that helps relieve pain and controls swelling. Apply ice packs or a bag of frozen peas wrapped in a thin towel to the site of the injury. You may find it helps to apply ice before and after completing your exercises. Do not apply ice directly to the skin. Do not leave the ice pack on for more than 20 minutes at a time in one hour. Repeat as much as required.
• Elevation: It is normal to experience swelling post injury.  Elevation reduces swelling, which in turn relieves pain and speeds up your healing.  Keep your injured limb elevated as much as possible during the first 72 hours. For lower limb injuries aim to get your foot above the level of your hips.
• Medication: A&E may have prescribed you with some pain relief. Take these as instructed to help keep on top of the pain. If you do not feel that this medication is helping, consider talking to a pharmacist or your GP to see if there is an alternative option.

Deep Vein Thrombosis (DVT)
When you are less mobile you are at higher risk of developing a blood clot, known as a deep vein thrombosis (DVT). Some patients require medication to reduce this risk.

If you develop signs of a DVT you need to seek urgent medical attention. The signs are:

• Swelling and tenderness in your calf and lower leg, rather than your knee.
• A change in colour of your toes compared with your other leg (typically purple)
• Pain in the calf, groin or chest area.
• Redness and heat in the affected area

Driving:
If you have an injury to your lower limb, you can return to driving when you no longer require the orthopaedic boot or crutches and are confident that you are able to do an emergency stop.

Work and Sport
Decisions to return to work are made on a unique basis and should be discussed with your GP and your employer. You may require a period of time off work and when you return you may need light or amended duties. The advice given will depend on your profession and your injury.

You can return to sport activities normally 6 weeks from injury, if comfortable and pain free.

Smoking with an injury
Medical evidence suggests that smoking prolongs fracture healing time. In extreme cases it can stop healing altogether. It is important that you consider this information with relation to your recent injury. Stopping smoking during the healing phase of a fracture will help ensure optimal recovery from this injury.

Physiotherapy:
If you have been referred to the Physiotherapy Department you can expect to hear from them in about 2-3 weeks, if you are worried that you have not heard from them please contact your local hospital and ask for the Physiotherapy Department.

Should you have any worries or concerns following your discharge from hospital please contact:

Virtual Fracture Clinic

07:00 – 14:30 Monday-Friday

Worcester Royal Hospital 01905 760 259

https://staging.worcsacute.mixd.co.uk/virtual-fracture-clinic

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.  

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