Emergency Care: Undisplaced Great Toe Fracture

Nikki Harrison

  • Reference Number: HEY1629/2026
  • Departments: Emergency Department, Major Trauma
  • Last Updated: 30 April 2026
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Introduction

This leaflet has been produced to give you general information about your injury and to back up the advice given to you when you attended the emergency care department. If you have any further queries or concerns, please use the contact details at the end of this leaflet.

What is an Undisplaced Great Toe Fracture?

The x-rays you have had following your injury show that you have sustained a fracture (break) in one of the bones of your big toe. It is undisplaced which means that it has not moved out of position and therefore should heal without the need for surgical intervention.

How should it be treated?

This injury can be treated with a firm soled shoe, a heel weight-bearing shoe or simply just by heel weight bearing until the pain settles, which is usually 3 to 4 weeks. You may initially require crutches but can wean off these as soon as you feel comfortable.

To manage your pain, we advise that you regularly take simple pain relief, which can be bought over the counter. If you have allergies or conditions, which prevent the use of pain-relieving medication, please seek advice from your doctor or a pharmacist.

Smoking

It is important to note that smoking will delay the healing process and so should be avoided. Talk to your GP, go to Quit smoking – NHS or download the app for more information

What should I do in the first few days?

Controlling the pain and swelling by following the principles of RICE are important:

R  REST

Complete rest is not advisable. If necessary, you will be given crutches to help you take some weight off the injured toe. Exercises in the section below, can be started straight away.

I    ICE

Ice will help reduce the pain in your toe and so should be applied for 10 to 15 minutes before performing any exercises. This will also help to reduce the swelling.

There are many ways in which ice can be applied however crushed ice, in the form of frozen peas for example, is the most effective. Whichever method you choose it is important that you wrap the ice in a damp towel, to prevent it from ‘burning’ the skin.

Please Note:

  • Only use an ice pack on areas that have normal skin sensation i.e. where you can feel hot and cold
  • Do not apply ice to an open wound
  • Do not apply an ice pack to an area that has poor circulation
  • When you apply ice to your skin, check the skin every five minutes and stop using it if:
    • the area becomes white, blue or blotchy
    • the area becomes excessively painful, numb or tingles

C   COMPRESSION

If you have been given a tubigrip to wear it is important this is removed if you develop any signs of poor circulation such as tingling, numbness, blueness of the skin of the foot and increasing pain. The tubigrip should be removed when you go to bed at night, as when you are asleep you cannot monitor these symptoms.

E    ELEVATION

The injured leg should be elevated above the level of the heart as much as possible, as this will reduce and prevent swelling.

What exercises should I do?

The simple exercises described below will help prevent stiffness developing in the ankle and foot.

Ankle dorsiflexion and plantarflexion

Pull your toes up towards you slowly and then point them down as far as you can.

Try to do this within your pain free range. Do not force the ankle or foot.

This range will increase as your injury heals.

Ankle inversion and eversion

Lie down on your back with the foot elevated so your heel does not touch anything, like on the picture opposite.

Slowly turn your foot/ankle in, then out (like a windscreen wiper), without moving the upper leg.

All photos with kind permission of ©Physiote

How long will the pain and swelling persist?

Pain and swelling can persist for 3 to 6 months following the injury. We advise continuing to use simple analgesia such paracetamol to help control your pain. Swelling is usually worse towards the end of the day. If this does occur, continue to use elevation as described previously.

When can I start driving again?

It is always good to check with your insurance company however, we advise it should be safe to return to driving when:

  • You are no longer using a firm soled or heel weight bearing shoe
  • You can walk comfortably without crutches
  • You can perform an emergency stop

When should I start increasing my activity?

Once you can walk normally, you should gradually increase your level activity. Consider trying the following exercises.

Stand facing a chair and step backwards with your injured foot.

Keep this leg straight with your toes pointing forward and the heel on the floor.

Now bend your other knee until you feel a stretch in the calf of your injured side. Hold this for 30 seconds and repeat three times per day

From the position in exercise, one move your injured foot forward but keep it slightly behind your other leg.

Ensure that your toes point forward and bend both knees, keeping the heel of your injured foot on the floor.

You should feel a stretch in the calf of your injured side.  Hold for 30 seconds and repeat three times per day.

Stand holding on to a chair, spread your weight equally over both feet and push up onto your toes as high as possible.

Hold for five seconds and slowly lower. Repeat 10 times, twice per day.

Once this becomes easier you can increase the number of repetitions or progress to repeating this stood on the injured leg on its own.

Stand on your injured leg and balance for as long as possible. To begin with, you may need to hold on to something solid to prevent you falling over.

As you improve, try doing functional activities such as washing the dishes or cleaning your teeth while you are standing on the one leg.

Try to hold your balance for up to 30 seconds.

All photos with kind permission of ©Physiotec™

If you participate in an active hobby then it is advisable that you do not return to this until you have full strength, full range of movement and you can walk briskly without experiencing pain and swelling.

If you play a sport, you can practice sports specific activities; like dribbling or jumping. Build up these exercises gradually from around 6 weeks, to help regain strength and flexibility, before returning to full training sessions and competition.

Do I require a follow up?

Do I need to be referred to Physiotherapy?

Most of the time, a referral to Physiotherapy is not needed and the advice in this leaflet is enough to help you recover.

However, if you have any concerns, are unable to follow the advice in this leaflet, or if you still have reduced movement, strength or function after 6 weeks, East Riding GP patients can contact the East Riding MSK Physiotherapy service on Tel: 01377 208300 or complete a self-referral form on https://www.chcpmsk.org.uk/self-referral-form-introduction.

Patients with a Hull GP should call Cora Health on Tel: 01482300003

However, it is important you seek urgent medical attention if you experience:

  • Severe pain, despite pain killers, that is worsening rather than improving
  • A change in the ability to bear weight on the injured leg
  • Significant swelling that continues to increase despite elevation
  • Numbness, tingling or unexpected weakness in the leg or foot
  • The leg or foot becoming cold, pale or blue
  • Signs of infection, such as fever or increasing redness, warmth or swelling in the affected leg.

If you are concerned regarding any of your symptoms, please attend your local Urgent Treatment Centre or call NHS111 who will direct you to the most appropriate place and may give you a specific appointment time.

 Your feedback matters to us…

To ensure we deliver a safe and quality service and to help us understand the experience you have of the care you receive from our staff we would value your thoughts about the service you received.

You may be contacted as part of our quality assurance programme which is where we visit our teams and staff and talk to them about the care they provide to our patients or at any time during or after you have needed our services.

To collect this feedback, we would contact you using the registered telephone number we hold in your care record. This feedback will be strictly anonymous and whilst we will share the feedback as part of the process, we will not share any details which may identify you.

We will never ask you any personal questions about your health during these telephone calls. If you do not wish to speak to us, please say this when we call, we do not want you to feel pressured.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.