Weiss Pediatric Care

Toe Injury

Definition

  • Injuries to toes

Call or Return If

  • Pain becomes severe
  • Pain not better after 3 days
  • Toe not normal after 2 weeks
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic

Types of Toe Injuries

  • Cuts, Scrapes and Bruises. These are the most common injuries.
  • Jammed Toe. The end of a straightened toe receives a blow. Most often, this is from kicking a ball while barefoot. The energy is absorbed by the joint surface and the injury occurs there.
  • Crushed or Smashed Toe. Most often, this is from a heavy object on falling the toe. The end of the toe may get a few cuts. Sometimes, the nail can be damaged. Broken bones are not common with this kind of injury.
  • Toenail Injury. If the nailbed is cut, it may need sutures to prevent a deformed nail. This is more important for fingernails.
  • Blood Clot under the Nail. Most often caused by a crush injury. This can be from a heavy object falling on the toe. Many are only mildly painful. Some are severely painful and throbbing. These need the pressure under the nail released. This can relieve the pain and prevent loss of the toenail.
  • Fractures or Dislocations. Most swollen, bruised and painful toes are not broken.

Symptoms

  • The main symptom is pain.

Prevention

  • Careful adult supervision of young children
  • Education of older children about high risk behaviors

 

After Care Advice

Bruised/Swollen Toe:
  • Soak in cold water for 20 minutes.
  • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed.
Small Cuts or Scratches:
  • For any bleeding, put direct pressure on the wound. Use a gauze pad or clean cloth. Press for 10 minutes.
  • Wash the wound with soap and water for 5 minutes.
  • For any dirt in the wound, scrub gently.
  • For any cuts, use an antibiotic ointment such as Polysporin. No prescription is needed.
  • Cover it with a Band-Aid. Change daily.
Jammed Toe:
  • Soak the foot in cold water for 20 minutes.
  • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed.
  • If the pain is more than mild, "buddy-tape" it to the next toe. Place a cotton ball between the toes before taping them together. Do this for a few days.
Smashed or Crushed Toe:
  • Wash the toe with soap and water for 5 minutes.
  • Trim any small pieces of torn skin with a fine scissors. Clean them first with rubbing alcohol.
  • For any cuts, use an antibiotic ointment such as Polysporin. No prescription is needed.
  • Cover it with a Band-Aid. Change daily.
  • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed.
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, cut it off. Use a pair of scissors that have been cleaned. Cut along the line of the tear. Reason: Pieces of nail taped in place will catch on objects.
  • Soak the foot for 20 minutes in cold water for pain relief.
  • Use an antibiotic ointment such as Polysporin. No prescription is needed. Then cover with a Band-Aid. Change daily.
  • After about 7 days, the nailbed should be covered by new skin. It should no longer hurt. A new nail will grow in over 6 to 8 weeks.
Pain Medicine:
  • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed.
Shoes to Reduce Pain:
  • If regular shoes cause too much pain, change footwear.
  • Wear a shoe with a firm sole to limit motion. Reason: Injured toes hurt when they bend.
  • If the top of the shoe increases pain, wear an open-toe sandal. Another option is to use an old sneaker. Then cut out the part over the toe.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2021 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
Article 2607