cut middle toe on rocks

by Vicky
(doncaster, UK )

I cut my toe on rocks near the beach on holiday in Vietnam, it was painful at the time but healed over. Now Im home, it's red, hot to touch and painful to walk on. It's also waking me up in the night due to shooting pains.

Could it be broken or infected?

RESPONSE

Hi Vicky,

Your toe could be infected, broken or you could have partially torn the tendon that is on the bottom of the toe. It could also just be badly bruised. I have no way of knowing since I cannot examine you.

But what that means is that you should have the toe examined by a doctor.

Of the possibilities I have mentioned, infection is probably the most dangerous. In general an infection will start 36-72 hours after trauma. In most cases the wound will not close over and drainage (pus) will occur at the site, but this is not always the case.

In theory if the wound was small enough, it could have closed over and then got infected which would cause the toe to swell, become red and hot, as well as painful.

I am not sure how hard you could have hit your toe on the rocks, but it certainly is possible that you broke a bone in the middle toe. Just like an infection, the toe could also be red, hot, swollen and painful as a result.

The only difference between the two is that if your toe is broken, that pain would have started immediately and would have been continuously painful since then. It would also tend to hurt the more you walk, while at rest, it would not be quite as painful.

An infection would not have hurt as much initially, would have begun a few days later and from that point worsened. It would tend to hurt equally whether you are walking or at rest.

If the rock you stepped on was sharp,enough to break the skin, then in theory you might have damaged the tendon on the bottom of the toe, perhaps even partially tore it.

This type of injury would also have made your toe, red, hot, swollen and painful as well. This type of injury would tend to hurt more when you walk and less when you are at rest.

Now, if the toe was nothing more than badly bruised, it should be getting progressively better rather than worsening. The only caveat here is that foot injuries tend to take longer to heal simply because walking on them makes them more painful and slows down the healing process.

I do not know how long you have been home from vacation so I have no way to judge where you should be in the healing process, if it was nothing more than a bruise.

Since there is a possibility of a broken bone and perhaps an infection, my opinion is that it does require medical attention. You should have it looked at as soon as possible because delaying treatment in a potential fracture or infection will only make matters worse.

If it is broken and not properly treated, you could end up with chronic pain in the toe. Contrary to what you might hear from some people, there is treatment for broken toes and a broken bone in a toe is no different then a broken bone anywhere else; it needs to be treated.

If there happens to be an infection and the wound has closed over, then the infection is not going to clear up on its own and so it too will require medical attention.

Marc Mitnick DPM
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