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First aid

Toe injury

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First Aid - Amputated Finger or Toe - Transport
First Aid - Amputated Finger or Toe - Transport

First Aid - Bleeding Toe
First Aid - Bleeding Toe

First Aid - Removing a Splinter
First Aid - Removing a Splinter

  • Injury the skin or nail of the toe
  • Injury to a bone, muscle, joint or ligament of the toe

Types of Injuries

  • Abrasions or Scrapes: An area of superficial skin that has been scraped off. Commonly occurs on the knuckles.
  • Bruises: Bruises (contusions) result from a direct blow or a crushing injury; there is bleeding into the skin from damaged blood vessels without an overlying cut or abrasion.
  • Cuts and Scratches: Superficial cuts (scratches) only extend partially through the skin and rarely become infected. Deep cuts (lacerations) go through the skin (dermis).
  • Fractures (broken bones)
  • Dislocations (bone out of joint)
  • Jammed or Stubbed Toe: The end of a straightened toe receives a blow (usually from kicking something). The ligaments and tendons of the toe are stretched and torn.
  • Smashed or Crushed Toe: This injury most often results from a heavy object falling on the toe. Usually the end of the toe receives a few cuts, a blood blister or a bruise. Sometimes the nail is damaged. A fracture of the bones inside the toe can occasionally occur.
  • Subungual Hematoma (blood under toenail): This medical term is applied when a blood clot forms under the toenail. It is caused by a crush injury to the tip of the toe. Some are only mildly painful and blood is typically less than 50% of nailbed. Others can be severely painful and throbbing, and these may need the pressure released to relieve pain. The pressure can be released by putting a small hole through the nail.  With larger subungual hematomas, the toenail will usually fall off. A new nail will grow back in 6 to 12 weeks.
  • Torn Nail: From catching it on something.

When are Stitches Needed?

  • Any cut that is split open or gaping probably needs sutures (stitches). Cuts longer than 1/2 inch usually need sutures.
  • A physician should evaluate any open wound that may need sutures regardless of the time that has passed since the initial injury.

If not, see these topics

First Aid:

FIRST AID Advice for Bleeding: Apply direct pressure to the entire wound with a clean cloth.

FIRST AID Advice for Penetrating Object: If penetrating object still in place, don't remove it (Reason: removal could increase bleeding).

FIRST AID Advice for Shock: Lie down with feet elevated.

FIRST AID Advice for a Sprain of the Toe:

  • Remove any rings or jewelry from the injured toe.
  • Tape the injured toe to the toe next to it (this is called a buddy splint).
  • Apply a cold pack or an ice bag (wrapped in a moist towel) to the area for 20 minutes.

FIRST AID Advice for Suspected Fracture or Dislocation of the Toe:

  • Remove any rings or jewelry from the injured toe.
  • Tape the injured toe to the toe next to it (this is called a buddy splint).
  • Apply a cold pack or an ice bag (wrapped in a moist towel) to the area for 20 minutes.

FIRST AID Advice for Transport of an Amputated Toe:

  • Briefly rinse amputated part with water (to remove any dirt).
  • Place amputated part in plastic bag (to protect and keep clean).
  • Place plastic bag containing part in a container of ice (to keep cool and preserve tissue).


When to Call Your Doctor

Call 911 Now (you may need an ambulance) If
  • Major bleeding (actively bleeding or spurting) that can't be stopped
  • Toe has been partially or completely amputated
  • NOTE: For bleeding, see First Aid
Call Your Doctor Now (night or day) If
  • You think you have a serious injury
  • Injury looks like a dislocated joint (crooked or deformed)
  • Bleeding that hasn't stopped after 10 minutes of direct pressure
  • Cut or scrape is very deep (e.g., can see bone or tendons)
  • Skin is split open or gaping and may need stitches
  • Blood present under the nail is causing severe pain
  • Toenail is torn from a crush injury or cut
  • Dirt or grime in the wound is not removed after 15 minutes of scrubbing
  • Toenail is completely torn off
  • Base of toenail has popped out from under skin fold
  • Cut or scrape looks infected (redness, red streak or pus)
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • You think you need to be seen
  • Cut or scrape and its been more than 10 years since last tetanus booster (5 years for dirty cuts and scrapes)
  • Diabetic with any toe injury
Call Your Doctor During Weekday Office Hours If
  • You have other questions or concerns
  • Injury interferes with work or school
  • Injury and pain have not improved after 3 days
  • Injury is still painful and swollen after 2 weeks
Self Care at Home If
  • Minor toe injury and you don't think you need to be seen

  1. Treatment of Cuts, Scratches and Scrapes (abrasions):
    • Apply direct pressure for 10 minutes to stop any bleeding.
    • Wash the wound with soap and water for 5 minutes.
    • Scrub out any dirt gently with a washcloth.
    • Cut off any pieces of dead loose skin using a fine scissors (cleaned with rubbing alcohol).
    • Apply an antibiotic ointment, covered by a Band-Aid or dressing. Change daily.
  2. Treatment of Bruised Toe: Soak the toe in cold water for 20 minutes.
  3. Treatment of Jammed Toe:
    • Caution - Be certain that there is no deformity (the toe lines up normally with the other toes).
    • Soak the toe in cold water for 20 minutes.
    • If the pain is more than mild, protect it by "buddy-taping" it to the next toe.
  4. Treatment of Smashed or Crushed Toe:
    • Apply an ice bag to the area for 20 minutes.
    • Wash the toe with soap and water for 5 minutes.
    • Trim any small pieces of torn dead skin with a scissors cleaned with rubbing alcohol.
    • Cover any cuts with an antibiotic ointment and Band-Aid. Change daily.
  5. Treatment of Subungual Hematoma (blood present under toenail): Apply an ice bag to the area for 20 minutes.
  6. Torn Nail (from catching it on something):
    • For a cracked nail without rough edges, leave it alone.
    • For a large flap of nail that is almost torn through, use a sterile scissors to cut it off along the line of the tear (Reason: pieces of nail will catch on objects and tear further).
    • Apply an antibiotic ointment and cover with a Band-Aid. Change daily.
    • After about 7 days, the nail bed should be covered by new skin and no longer hurt. It takes about 6-12 weeks for a toenail to grow back completely.
  7. Pain Medication:
    • For pain relief, take acetaminophen or ibuprofen.
    • Acetaminophen (e.g., Tylenol): The dose is 650 mg by mouth every 4 hours or 1000 mg by mouth every 6 hours. Maximum dose per day = 4000 mg.
    • Ibuprofen (e.g., Motrin, Advil): The dose is 400 mg by mouth every 6 hours or 600 mg by mouth every 8 hours.
    • People who are over 65 Years of age: Acetaminophen is generally considered safer than ibuprofen. Acetaminophen dosing interval should be increased to every 8 hours because of reduced liver metabolism. Maximum dose per day = 3000 mg.
    • CAUTION: Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
    • CAUTION: Do not take acetaminophen if you have liver disease.
    • Read the package instructions thoroughly on all medications that you take.
  8. Call Your Doctor If:
    • Cut or scrape looks infected (redness, red streak or pus)
    • Pain becomes severe
    • Pain does not improve after 3 days
    • Pain or swelling lasts more than 2 weeks
    • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: David A. Thompson, M.D.

Last Reviewed: 1/19/2009

Last Revised: 4/5/2008

Content Set: Adult HouseCalls Online

Portions Copyright 2000-2009 Self Care Decisions LLC; Copyright LMS, Inc.

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