A fracture can happen in any bones of the body, be it a small or a big bone. Fractures can be of many types like simple, compound, complete or incomplete. The diagnosis is one based on the condition of the bone. A fracture could be either complete where the bone breaks into two or more parts or incomplete where the bone is broken yet is stable and not separated. Simple fracture happens when a bone is broken but is not visible and the skin remains intact; while compound fracture happens when the broken bone protrudes outside the skin. Compound fracture can happen in any bone and can be very serious as they have the potential of damaging the nearby tissues and blood vessels. Compound Fractures of toe bones or phalangeal bones occur when the toe bones undergo severe injury due to which the bone fragments or the ends of the broken bone protrude out of the skin. The injury is exposed and is visible to the eye.
Compound Fracture of Toe Bones (Phalanges)
The foot is rather an important as well as complicated part of the body because it not only allows us to move from one place to another but also bears the weight and balances our body. The skeletal structure of feet constitutes fourteen phalanges, five metatarsals and seven tarsals. The phalanges make up the toe bones, three each for the lesser toes and two for the thumb. The metatarsals are long bones that connect the toes to the heels and the tarsals make up the heel and the back of the foot.
When fractures occur in the phalanges, the weight bearing ability and balance of the body is lost along with impaired range of motion of the toes. This becomes extremely severe when the fracture is an open fracture because it greatly increases the chances of infection of the bone and the adjoining muscles, tendons and ligaments.
Symptoms of Compound Fracture of Toe Bones (Phalanges)
The symptoms for compound fractures of toe bones are:
- When the bone breaks one can hear the breaking sound
- Immediate pain which is severely traumatic
- Extreme tenderness in the area of injury
- Bleeding from bones and the site of injury
- Development of swelling
- Limited or no movement of foot
- Inability in putting of the weight on the foot.
Prognosis of Compound Fracture of Toe Bones (Phalanges)
The toes with compound fracture usually take more than six weeks to heal owing to the severity of the condition and presence or absence of infection in bone or the surrounding areas. The compound fracture cases need immediate medical attention or else these may result in serious complications which could even lead to deformity.
Causes of Compound Fracture of Toe Bones (Phalanges)
There can be various causes to compound fractures of toe bones:
- Playing sports especially football
- Weak bones
- Crushing injury with heavy objects.
Risk Factors for Compound Fracture of Toe Bones (Phalanges)
The factors that pose a threat of compound fractures of toe bones are:
- Presence of skin necrosis
- Prior involvement in high impact sports
- Usage of faulty sports equipment and following of faulty technique
- Occupations that require crush injury or dropping of heavy objects.
Complications due to Compound Fracture of Toe Bones (Phalanges)
The possible complications associated with compound fractures of phalanges are:
- Amputation of the affected foot due to wound contamination
- Development of arthritis
- Joint pain and stiffness
- Deformity of foot
- Developments of compartment syndrome as result of pressure build up due to swelling and inflammation at the site of injury.
Diagnosis of Compound Fracture of Toe Bones (Phalanges)
The diagnosis of compound fracture is not difficult because the injury causes a break in the skin as a result of which the flesh and bone fragments are exposed. The diagnosis may also involve checking of damage to the adjoining blood vessels and nerves. To check the extent of damage, imaging tests like X-Ray and MRI can be opted.
Treatment of Compound Fracture of Toe Bones (Phalanges)
The treatment follows below procedures:
- Antibiotic Treatment for Compound Fracture of Toe Bones: Antibiotics are given immediately to the patient to limit the chances of possible infections to the site of injury.
- Debridement and Irrigation as a Method of Treatment of Compound Fracture of Phalanges: This procedure involves washing of the wound with saline solution and then removal of any foreign or other bone debris from the site of injury. It is done to stabilize the injury and to prevent any further damage.
- Fixation of the Toe Bones due to Compound Fracture: Once the injury has been stabilized fixators are placed to keep the bones in place to ensure proper union of the bones. The fixators can be internal as well as external. In case of external fixators, outer support structures like ring are placed on the toes to keep the bones in place whereas in case of internal fixators pins and screws are fixed to the bones for proper alignment.
- Reduction Surgery to Treat Compound Fracture of Toe Bones: The reduction surgery is done in the cases where the broken bones do not fix appropriately; in such cases, doctors opt for surgical reduction of the bone by following minimal invasive measures and keeping bone loss to the minimal possible level. This surgery allows significant bone alignment.
- Splint and Cast Support for Compound Fracture of Toe Bones: Cast and splint support is required to provide support and stability to the toe. A splint provides a cushioned support to allow the wound to heal properly. The cast support on the other hand is a plaster casing over the toe to allow complete bone healing with minimal displacement for accelerated healing.
Prevention of Compound Fracture of Toe Bones (Phalanges)
There are certain preventive measures that can be followed to prevent the occurrence of such a condition are:
- Wearing strong and sturdy shoes that provide required support.
- Maintaining appropriate caution in work environments with possibility of crushing injury.
- Wearing and using appropriate equipment’s and accessories while playing any sport.
- Cautiously playing foot related sports like football.
Compound fracture of toes is a very serious condition in which the bones or fragments of bones stick out of the skin. The condition requires immediate attention due to extreme traumatic pain and underlying possibility of infection to the broken bone and the surrounding areas. The treatment requires surgical cleaning with appropriate bone alignment procedure. The recovery time is usually over six weeks and healing requires loads of rest which if not taken can result in serious complications.
- American Academy of Orthopaedic Surgeons: “Fractures (Broken Bones)” – https://orthoinfo.aaos.org/en/diseases–conditions/fractures-broken-bones/
- Cleveland Clinic: “Fracture” – https://my.clevelandclinic.org/health/diseases/17813-fracture