Avulsion fracture – 2nd toe – not healing

I have an avulsion fracture, 2nd toe in the joint that is closest to the nail. The same toe actually had two fractures both crossing a joint but the other one healed. The avulsion fracture is not healing even though it is in a good position. I’ve been having x-rays every couple of months since April and nothing has changed. At this point I’ve been told it won’t heal. Being very athletic, this is a big problem for me. I asked about having the toe amputated at the first joint but the surgeon refused. Is bone stimulation a viable option? Any other suggestions? I do have an image I can send.

4 Responses

  1. Foot-com

    Hello and thank you for your follow up.

    If you have not had any imaging then you cannot guarantee that you have an avulsion fracture – especially for a digit as this is very rare. Something doesn’t sound complete in your explanation or recommendations and without seeing your foot it is very difficult for me to accurately advise you.

    I would either provide a picture demonstrating where your pain is or get a 2nd opinion from a Podiatrist in your area.

    Thank you!

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    Dr. Emily Splichal
    Please be advised: we do not provide medical advice, diagnosis or treatment.
    By law, we cannot give specific medical advice over the Internet.

  2. Foot-com

    Thank you for your reply. The avulsion fracture was diagnosed by two ortho surgeons. Even though you are saying that there is little loss of function (great news!!), my problem is I can’t put any type of hard pressure on the joint. I can walk with it but when I even attempt to play any sports (raquet), it instantly feels like I’ve rebroken my toe again. I desperately want to be able to return to sports and unfortunately for me those all include putting pressure on that joint even though I assume most pressure lands on the big toe. Do you think if I ask if they will surgically remove the piece of bone, this will allow me to return to sports? I’m not exactly sure what causes the toe to instantly feel like I broken it again. Is it the piece of bone that is causing this painful feeling?

  3. Foot-com

    Hello and thank you for your question.

    What tendon is associated with the avulsion fracture? And who diagnosed it as an avulsion fracture? If it is a true avulsion fracture then I agree that it most likely will not heal as these bones are so small.

    The good news is there is very little loss of function with this type of fracture in the digit – especially at the distal joint.

    You are now 5 months past the fracture that a bone stimulator won’t do much for it either. I would just accept that it is not going heal and proceed. Also no surgeon will amputate at the joint as there is no benefit to this procedure you are suggesting.

    Good luck.

    ==============
    Dr. Emily Splichal
    Please be advised: we do not provide medical advice, diagnosis or treatment.
    By law, we cannot give specific medical advice over the Internet.

  4. Enrique Gumucio

    Hi. My daughter had an avulsion fracture on her big toe after a gymnastics injury. She had surgery to repair it this past March. After surgery, she started her PT and slowly went back into gymnastics. Unfortunately the pain continued and it even increased as time went by to the point that she could not sleep well at night. The pain felt like pinching needles underneath the big toe. After further review, it appeared that there was a great deal of scar tissue surrounding the toe, which may have been affecting the nerve. After a second surgery two weeks ago, the doctor was able to remove all scar tissue and confirm that everything else on the toe looked anatomically correct, including an anchor he placed on the first surgery. She has now been going to PT and the toe still hurts quite a bit. It is however a different type of pain. More like a pressure type pain. As you can probably tell she is extremely frustrated with having pain to the toe for so many months… I have two questions: Is the pain normal? what can she do to reduce/help alleviate the pain?

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