Patient: Hello Doctor, I am a 45 year old female who stubbed her toe 1 month ago. I thought it was nothing but after a month of not improving, I went to see my doctor who did an Xray which showed a minimally displaced intra articular avulsion fracture arising from the dorsal base of the distal phalanx of the right third toe. My question is: What do you recommend for management: surgery, bracing, immobilization, something else and why? What should be done for treatment monitoring? I am otherwise healthy.
Doctor: The management of such an injury will depend on several factors, cheifly, the symptoms associated with the injury, the d egree of displacement and any other associated injuries such as injuries to ligaments and tendons . Given the “minimal displacement”, location of the injury and time since injury, I am inclined to think that immobilization by an appropriate splint with the addition of anti-inflammatory medication should be adequate treatment. Please note, that there is a increased risk of developing osteoarthritis in this joint since the fracture involves the joint surface. Other potential complications include deformity of the toe and some loss of motion.