TOE INJURY
Injury Definition
- Injury the skin or nail of the toe.
- Injury to a bone, muscle, joint or ligament of the toe.
Types of Injuries
- Cuts and Scratches: Superficial cuts (scratches) only extend partially through the skin and rarely become infected. Deep cuts (lacerations) go through the skin (dermis).
- Abrasions or Scrapes: An area of superficial skin that has been scraped off. Commonly occurs on the knuckles.
- Bruises: Bruises (contusions) result from a direct blow or a crushing injury; there is bleeding into the skin from damaged blood vessels without an overlying cut or abrasion.
- Fractures (broken bones)
- Dislocations (bone out of joint)
- Jammed Toe: The end of a straightened toe receives a blow (usually from kicking something). The ligaments and tendons of the toe are stretched and torn.
- Crushed Toe: This injury most often results from a heavy object falling on the toe. Usually the end of the toe receives a few cuts, a blood blister or a bruise. Sometimes the nail is damaged. A fracture of the bones inside the toe can occasionally occur.
- Subungual Hematoma (blood under toenail): This medical term is applied when a blood clot forms under the toenail. It is caused by a crush injury to the tip of the toe. Some are only mildly painful and blood is typically under < 50% of nailbed. Others can be severely painful and throbbing, and these may need the pressure released to relieve pain. The pressure can be released by putting a small hole through the nail. With larger subungual hematomas, the toenail will usually fall off. A new nail will grow back in 6 to 12 weeks.
- Torn Nail: From catching it on something.
When are Stitches Needed?
- Any cut that is split open or gaping probably needs sutures (stitches). Cuts longer than 1/2 inch usually need sutures.
- A physician should evaluate any open wound that may need sutures regardless of the time that has passed since the initial injury.
See More Appropriate Topic (instead of this one) If
- ANIMAL BITE to toe
- BURN of toe
- SPLINTER OR SLIVER in toe
- PUNCTURE WOUND to toe
WHEN TO CALL YOUR DOCTOR FOR TOE INJURY
Call 911 Now (you may need an ambulance) If
- Major bleeding (actively bleeding or spurting) that can't be stopped
- Toe has been partially or completely amputated
- First Aid: Apply direct pressure to the entire wound with a clean cloth.
Call Your Doctor Now (night or day) If
-
You think you have a serious injury
- Injury looks like a dislocated joint (crooked or deformed)
- Bleeding that hasn't stopped after 10 minutes of direct pressure
- Cut or scrape is very deep (e.g. can see bone or tendons)
- Skin is split open or gaping and may need stitches
- Blood present under a nail is causing severe pain
- Toenail is torn from a crush injury or cut
- Dirt or grime in the wound is not removed after 15 minutes of scrubbing
- Toenail is completely torn off
- Base of toenail has popped out from under skin fold
- Cut or scrape looks infected (redness, red streak or pus)
Call Your Doctor Within 24 Hours (between 9am and 4pm) If
- You think you need to be seen
- Cut or scrape and its been more than 10 years since last tetanus booster (5 years for dirty cuts and scrapes)
- Diabetic with any toe injury
Call Your Doctor During Weekday Office Hours If
- You have other questions or concerns
- Injury interferes with work or school
- Injury and pain have not improved after 3 days
- Injury is still painful and swollen after 2 weeks
Self Care at Home If
- Minor toe injury and you don't think you need to be seen
HOME CARE ADVICE FOR MINOR INJURIES OF TOE
- Treatment of Cuts,
Scratches and Scrapes (abrasions):
- Apply direct pressure for 10 minutes to stop any bleeding.
- Wash the wound with soap and water for 5 minutes.
- Scrub out any dirt gently with a washcloth.
- Cut off any pieces of dead loose skin using a fine scissors (cleaned with rubbing alcohol).
- Apply an antibiotic ointment, covered by a Band-Aid or dressing. Change daily.
- Treatment of Bruised Toe: Soak the toe in cold water for 20 minutes.
-
Treatment of Jammed Toe:
- Caution - Be certain that there is no deformity (the toe lines up normally with the other toes).
- Soak the toe in cold water for 20 minutes.
- If the pain is more than mild, protect it by "buddy-taping" it to the next toe.
-
Treatment of Smashed or Crushed Toe:
- Apply an ice bag to the area for 20 minutes.
- Wash the toe with soap and water for 5 minutes.
- Trim any small pieces of torn dead skin with a scissors cleaned with rubbing alcohol.
- Cover any cuts with an antibiotic ointment and Band-Aid. Change daily.
- Treatment of Subungual Hematoma (blood present under toenail): Apply an ice bag to the area for 20 minutes.
-
Torn Nail (from catching it on something):
- For a cracked nail without rough edges, leave it alone.
- For a large flap of nail that's almost torn through, use a sterile scissors to cut it off along the line of the tear (Reason: pieces of nail will catch on objects and tear further)
- Apply an antibiotic ointment and cover with a Band-Aid. Change daily.
- After about 7 days, the nail bed should be covered by new skin and no longer hurt. It takes about 6-12 weeks for a toenail to grow back completely.
-
Pain Medication: For pain relief, take acetaminophen every 4-6 hours
(e.g. Tylenol; adult dosage 650 mg) OR ibuprofen every 6-8 hours (e.g. Advil,
Motrin; adult dosage 400 mg).
- Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
- Do not take acetaminophen if you have liver disease.
- Read the package instructions thoroughly on all medications that you take.
- Call Your Doctor If:
- Cut or scrape looks infected (redness, red streak or pus)
- Pain becomes severe
- Pain does not improve after 3 days
- Pain or swelling lasts more than 2 weeks
- You become worse or develop any of the "Call Your Doctor" symptoms.
Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
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