Pearls

• Perform a careful neurovascular exam with evaluation of medial/lateral sensation and capillary refill.
• Most toe fractures can be reduced with local nerve blocks.
• Consider placing a sheet of cotton between the fractured toe and the adjacent toes before buddy taping.

Complications

Occasionally toe fractures cannot be reduced and require surgical stabilization. This is most important for the great toe.

Outpatient orthopedic evaluation for the following post-reduction situations:

1. Displaced intraarticular fractures
2. >20° angulation in the dorsal plane
3. >10° angulation in the mediolateral plane
4. >20° rotational deformity, physis fractures