The X-files

Marshall Deltoff
October 01, 2008
Written by Marshall Deltoff
toefxThis 62-year-old woman presented with severe pain in the fourth right toe. She relates that she always walks around the house barefoot, and bumped her foot against a heavy chair.

Radiographs reveal an oblique fracture of the proximal phalanx of the fourth digit. (Figure A). Diagnosis: Bedroom fracture.

OUCH!! Turn on the lights, get the ice pack, and let’s review toe fractures. There are three main etiologies of phalangeal fractures in the foot:

a) crush injuries: typically comminuted fracture of one or more phalanges, caused by dropping a heavy object on the foot
b) bedroom fracture: typically oblique, this fracture is caused by a direct blow to the side of a toe, such as striking a hard object with a bare foot (like the foot of the bed in a dark bedroom)
c) chip fracture: a small avulsion of a flake of bone, usually near a phalangeal articular margin, typically following digital hyperextension

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