Foot fractures most often involve the metatarsals (the long bones of the forefoot) and the toes; they cause pain, swelling and bruising, and the diagnosis is confirmed with an X-ray [2][3]. Most heal without surgery: the smaller toes are taped to the toe next to them and a stiff-soled shoe is worn, and for metatarsal fractures a cast or walking boot is used [2][3]. Toe fractures usually heal in 4 to 6 weeks, and metatarsal fractures heal enough for weightbearing in 6 to 8 weeks; a broken big toe, open or displaced fractures and the Jones fracture need closer follow-up [1][2][3].
What is a broken foot or broken toe, and how does it happen?
The front part of the foot contains five metatarsal bones and 14 toe bones [2]. Toe fractures are the most common fractures of the foot [3].
The main causes are hitting the foot against something hard, dropping a heavy object on the toes, a crush or twisting injury of the foot and a fall from height [2][3][4]. Stress fractures, which develop with repeated loading, are the subject of a separate article [2].
How can you tell if the foot is broken?
The most common symptoms are pain and swelling [2]. How much weight can be put on the foot varies with the extent of the fracture and the person's pain tolerance [4]. You may not be sure whether a toe is broken or just bruised; treatment is usually the same for both [1].
A fracture that is not treated can lead to chronic foot pain; if you think you have a fracture, see a doctor as soon as possible [2]. The following signs suggest a fracture [1][2][4]:
- Bruising that may extend to nearby parts of the foot
- Pain with walking and weightbearing
- Tenderness at a single point over the bone
When is an X-ray needed?
The diagnosis is confirmed with an X-ray; three views of the foot or toe are taken [3][4]. After a sprain-type injury, the Ottawa rules help decide whether an X-ray is needed [4]: a foot X-ray is taken if there is pain in the midfoot together with tenderness at the base of the fifth metatarsal or at the navicular bone, or if no weight can be put on the foot immediately after the injury and at the examination [3].
If the injured toe is not the big toe, the bone is not sticking out, the toe is not pointing at an odd angle and there is no wound, doctors usually suggest starting treatment at home; if the pain and swelling have not eased after five days, a doctor may request an X-ray [1]. Joint injuries of the midfoot (Lisfranc injuries) are often overlooked; when one is suspected, the X-ray is taken with weight on the foot [4].
A broken toe: how is it strapped, and is a cast needed?
Most toe fractures can be treated without surgery [2][4]. For the smaller toes, including the little toe, the initial treatment is to tape the toe to the one next to it, wear a stiff-soled shoe and walk as far as pain allows; a cast or boot is used mainly for fractures of the big toe [3].
To strap the toe, put a small piece of cotton wool or gauze between the sore toe and the toe next to it and tape the two together; the strapping stays on for 2 to 3 weeks [1]. Do not strap the toe if it is pointing at an odd angle or if the injured toe is the big toe [1].
Depending on the source, the stiff-soled shoe is used for 2 to 6 or for 4 to 6 weeks [3][4]. A pharmacist or doctor can advise on a painkiller [1]. The following are recommended at home [1]:
- Resting the foot and keeping it raised while it is swollen
- In the first few days, holding ice wrapped in a towel on the toe for up to 20 minutes every few hours
- Wearing wide, flat shoes with stiff soles; avoiding tight, pointed shoes
- Not walking for long periods in the first few days; taking a break from sports such as football for 6 weeks or until the pain eases
A broken big toe, displaced fractures and open fractures
The big toe is watched more closely because of its role in weightbearing [4]. A big toe fracture is generally treated for 2 to 3 weeks in a short leg walking cast or a walking boot; after that, if there are no significant symptoms, treatment continues with taping and a stiff-soled shoe for 3 to 4 weeks [3]. Healing typically takes 4 to 6 weeks; return to work and sport can take 6 to 8 weeks [3].
If the bone ends have separated (a displaced fracture) and the toe looks crooked, the doctor may need to put the fracture back into position under local anaesthetic [2]. A fracture with a dislocation, displaced fractures that involve the joint surface and, in children, growth plate fractures are assessed by an orthopaedic specialist [3].
If the skin is broken (an open fracture), bacteria can enter the wound and cause infection in the bone; immediate treatment is required [2].
A broken metatarsal: boot, cast or surgery
In most metatarsal fractures the foot is first kept raised and weightbearing is limited, followed by gradual weightbearing in a cast or walking boot [2]. For fractures of the shaft, a splint and crutches are used first; if the follow-up X-ray shows that the fracture is stable, the next step is a walking cast or a boot [3]. Depending on the source, the time in a cast, boot or stiff-soled shoe is 3 to 6 or 4 to 6 weeks [3][4].
Surgery is not usually required; it may be needed if several metatarsals are broken together and the foot is deformed or unstable [2].
The fifth metatarsal: avulsion fracture and Jones fracture
About 30% of metatarsal fractures are at the base of the fifth metatarsal, the bone that leads to the little toe [5]. This fracture usually happens when the foot and ankle are twisted downward and inward [2].
In an avulsion fracture, the ligament attached to the base of the bone pulls a small fragment of bone away [2]. Nondisplaced ones are generally treated with a compressive dressing and weightbearing as tolerated, and those displaced by less than 3 mm with a walking boot, generally for two weeks; healing takes 4 to 8 weeks [3]. In a randomised trial included in a systematic review, patients with these fractures who were given early functional treatment instead of immobilisation returned to work sooner (11 versus 28 days), with otherwise similar outcomes [5].
A Jones fracture is a transverse fracture at the base of the same bone, in the area closer to the shaft; because the blood supply of this area is poor, healing may be delayed and the rate of nonunion is high [2][3]. Non-surgical treatment is a splint first, followed by 6 to 8 weeks in a non-weightbearing short leg cast; immobilisation typically lasts 6 to 10 weeks and healing takes up to 12 weeks [3]. If there are concerns about delayed healing or the person is highly active (for example a competitive athlete), surgery may be recommended as the initial treatment [2]. In another randomised trial in the same review, surgery gave better results than immobilisation for fractures in the part of the base closest to the shaft [5].
How long does healing take, and what helps?
Toe fractures usually heal within 4 to 6 weeks, but it can sometimes take several months [1]. It may take 6 to 8 weeks to walk comfortably in normal shoes; it is normal for the toe to remain achy and swollen for 3 to 6 months [2]. Metatarsal fractures usually heal enough for weightbearing in 6 to 8 weeks, but this may take longer [2].
A broken bone needs adequate nutrition to heal: a healthy, well-balanced diet that includes protein, calcium, vitamin C and vitamin D is the best way to ensure this; dietary supplements that go beyond the daily requirements are not effective [7]. Fractures take longer to heal in smokers [6]; tobacco or nicotine in any form inhibits bone healing and increases the chance of nonunion [7].
See a doctor if the pain and swelling have not eased after five days or if it still hurts to walk six weeks later [1]. Fracture healing and cast care are described in a separate article.
When not to wait
Fractures are seen through the hospital's emergency department; no appointment is needed. Seek care without waiting in the following situations; in the first five, go straight to the emergency department [1][2]:
- You think you have broken your big toe
- The toe is pointing at an odd angle or the foot has changed shape
- The bone is sticking out through the skin
- There is tingling or numbness in the toe or foot
- The injured person is a child; do not treat a child's toe injury yourself
- There is a bad cut or wound, or the pain is severe
- You have diabetes and have injured a toe
Frequently asked questions
- Does a broken toe need a cast?
- For the smaller toes, treatment is generally taping the toe to the one next to it and a stiff-soled shoe [3]. For a broken big toe, a short leg walking cast or a walking boot may be used for 2 to 3 weeks [3].
- How do you strap a broken toe at home?
- A small piece of cotton wool or gauze is placed between the two toes and the broken toe is taped to the toe next to it; the strapping stays on for 2 to 3 weeks [1]. If the toe is pointing at an odd angle or the injured toe is the big toe, do not strap it; go to the emergency department [1].
- How long does a broken foot stay in a cast or boot?
- It depends on which bone is broken: 3 to 6 weeks for metatarsal shaft fractures [3][4], generally two weeks in a boot for an avulsion fracture of the fifth metatarsal, and 6 to 10 weeks in a cast for a Jones fracture [3].
- How many weeks do a broken foot and a broken toe take to knit?
- Toe fractures usually heal within 4 to 6 weeks, but it can sometimes take several months [1]. Metatarsal fractures usually heal enough for weightbearing in 6 to 8 weeks [2]; with a Jones fracture, healing can take up to 12 weeks [3].
- What helps a broken foot, and which foods help the bone heal?
- A healthy, well-balanced diet that includes protein, calcium, vitamin C and vitamin D is recommended; supplements that go beyond the daily requirements are not effective [7]. Fractures take longer to heal in smokers [6]. Resting the foot, keeping it raised while it is swollen and applying ice in the first few days are also recommended [1].
This article is a general summary; diagnosis and treatment decisions are made by the doctor who examines you.
Sources
- Broken toe. NHS (nhs.uk), 2026. nhs.uk
- Toe and Forefoot Fractures. American Academy of Orthopaedic Surgeons (OrthoInfo), n.d.. orthoinfo.org
- Diagnosis and Management of Common Foot Fractures. American Family Physician (Bica D, et al.), 2016. pubmed.ncbi.nlm.nih.gov
- Common Foot Fractures. American Family Physician (Silver S, et al.), 2024. pubmed.ncbi.nlm.nih.gov
- Fifth Metatarsal Fracture–A Systematic Review of the Treatment of Fractures of the Base of the Fifth Metatarsal Bone. Deutsches Ärzteblatt International (Herterich V, et al.), 2021. pubmed.ncbi.nlm.nih.gov
- Smoking and Musculoskeletal Health. American Academy of Orthopaedic Surgeons (OrthoInfo), n.d.. orthoinfo.org
- Nonunions. American Academy of Orthopaedic Surgeons (OrthoInfo), n.d.. orthoinfo.org
This article is general information and does not replace an examination or imaging. If you have symptoms, see a doctor.
More in this area
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- Ankle sprain: when is an X-ray needed?
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- Flat feet: do children outgrow them, and when are insoles or surgery needed?
- Foot pain: what causes it, what helps and which specialist to see?
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