Weird pinky toe issue...different from past broken toes

by Kristi
(Usa)

Over a week ago, I closed a door over my pinky toe. In the process of pulling my foot up and out of the way, I heard/felt a crack and felt immediate pain in my toe. Within an hour I had dark bruises and minor swelling. The skin along the 5th metatarsal toe and foot went cold and numb. The numbness went away the next day. One bruise was on the bottom of my 5th toe...mostly under the intermediate and proximal phalanges of the 5th metatarsal, and inside of the toe. That bruise cleared up in a week, but the pain is still a problem if I don't have it wrapped. The second bruise is on the top part of my foot...kind of between the tendons running from the 4th and 5th toes. That bruise has all but disappeared, except for a strange lingering pin sized mark a little further away from the toe. Overall, the size of my toe is now consistent with my pinky toe on the other foot, which I've broken twice and remained enlarged since the second injury years ago. I didn't go to the doctor as she was out of town. I knew that whether sprained or broken, I could do what a doc would've done with tape and ice.

11 days later, my toe is still mostly buddy wrapped. It doesn't really look remarkable at all. Just putting on a closed toe shoe brings excruciating pain; I definitely can't walk in one. When I unwrap my toe and move around, the area swells up a little. I'm more bothered by the fact that the toe feels like it is lacking the strength and structure that all my other toes have. It doesn't have the pushback that my other pinky toe has, it almost gives in. This is different from past broken toes.

Today, I took my dogs on a short walk in flip flops (toes buddy taped). I know the flip flops aren't smart to wear but there is no other choice with the pain that comes from a closed toe shoe. No pain the first part of the walk, but on the way back it started to hurt. It got worse when one of my dogs stepped on it. I came back with sore tendons in the 5th metatarsal region up into my ankle and shin. (Might be because I tend to flex my foot when I walk to avoid pushing off my hurt toe.) I untaped and tried to spread my toes when the inside of my pinky toe shot out a sharp pain into my foot. I didn't notice any swelling, but ever since I get random minor shooting pains. 8 years ago in my opposite foot, I partially ruptured my peroneus longus and p brevis tendons, as well as broke my 5th metatarsal in two places along the foot. I didn't really respect the healing process and pretty much was in a boot or walking shoe and crutches for 6 months (they originally had estimated a 2 month healing period). I don't want to do that again! I guess my question is does this sound like a broken or sprained toe? Something else? My doctor is still out of town and I can't get in to see the covering MD for a while. My tentative plan is to retape my toes and stay off my foot as much as possible for the next week then reassess. Does this sound reasonable or should I go in to a urgent care place?

RESPONSE

Hi Kristi,

The only way to know if the toe is broken is with an x-ray, plain and simple. Don't ask me to guess because I usually guess wrong.
The sooner you get the x-ray the better. I would recommend going to urgent care. In the meantime you should keep the toes taped and wear a rigid shoe.
The quicker the toe is properly treated, the less likely you will be dealing with this problem for the next six months.

Marc Mitnick DPM