Baby toe shorter after fracture

by Dori
(Gilbert, AZ)

I had a displaced fracture of the 5th metatarsal and didn't have surgery. I was non weight bearing for 9 weeks. Then doctor said okay to resume all activities. My baby toe is shorter than it was and it presses into the other toe. Wearing shoes is uncomfortable and my job requires me to be on my feet 8-10 hours a day. Is this normal and is there anything I can do to relieve pain?

RESPONSE
Hi Dori,

The fact that you had a displaced fracture of the fifth metatarsal bone means that the bone no longer lines up as it originally did before your fracture.
I do not have the luxury of seeing the x-rays but in most cases, the distal portion (the front portion) of bone is moved in a different location as a result of the trauma.
What this does, depending on the severity of the displacement, is re-position the angle of the fifth toe.
The bone then heals and depending on the severity of the displacement will be in such a position that it ends up shorter relative to its original length. This in turn appears to make the fifth toe appear shorter.
Now that the fifth toe is mal-aligned relative to the fourth toe, it is apparently pressing into the fourth toe and causing discomfort.
This of course will be exacerbated by shoes, particularly dress shoes.
So what can you do?
The simplest thing you could try would be to place a sponge pad in between the toes. It is not a cure but if it works it solves your problem without too much effort.
The only other way to solve the problem would require a surgical approach. In its simplest form, depending on what part of the fifth toe is pressing into the fourth toe, small portions of bone could be removed from each toe which would alleviate the bone to bone pressure that is causing your pain.
This type of surgery would not create too much down time and may very well solve your problem. Of course I am basing this on certain assumptions and again I do not have the luxury of viewing your x-ray or your foot for that matter.
The much more involved procedure would be to re-fracture the healed metatarsal fracture. This would probably require a bone graft to increase the length of the bone. Additionally, the metatarsal bone would need to be re-aligned to resemble as much as possible the position of the bone before the original fracture.
I am not sure this is viable option for most people but it is food for thought.
Changing the style of your shoes to a more boxy conservative style might be of help, but in all honesty it is probably the least realistic.
I would suggest you go back to your doctor, hopefully he or she is a foot specialist, and discuss the matter and decide what course would be best for you.

Marc Mitnick DPM
DISCLAIMER: