# Broken big toe - why do I need to see an ortho doctor?



## klpca (Aug 15, 2013)

I broke my big toe on Saturday night, and it was confirmed with xrays today. I have it in a boot and have a referral to see an orthopedic surgeon on Tuesday. 

Any idea why I have been referred to an orthopedic surgeon? Is that the same as an orthopedist?

One more bit of info - I severely broke this same toe 12 years ago while on vacation on the big island but just taped it to the next toe. I found out two years later that it should have been properly set as it now has arthritis and it has caused other problems with my foot. Would they try to reset the original injury?


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## Clemson Fan (Aug 15, 2013)

klpca said:


> One more bit of info - I severely broke this same toe 12 years ago while on vacation on the big island but just taped it to the next toe. I found out two years later that it should have been properly set as it now has arthritis and it has caused other problems with my foot.



Doesn't this answer your original question???


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## VacationForever (Aug 15, 2013)

Well... someone I know had an old toe injury and hurt it again and he took too long to see a doctor.  The surgeon told him the toe had died and the surgeon chopped off quite a bit more than the 1 toe,... still in the hospital as he now has an infection.  If this does not scare you then I don't know what will...


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## Phydeaux (Aug 15, 2013)

Just go see the ortho doc...


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## klpca (Aug 15, 2013)

Thanks for the information. I already have an appointment scheduled for Tuesday. It was just weird to go from an appointment where the doctor didn't think my toe was broken but did x-rays to be sure, to then get the message to see a surgeon. I wasn't expecting that. I didn't think the toe could be reset 12 years later, but I guess I'll find out next week.

Even now I'm peeved that I listened to a nurse at the wedding, "don't be a baby - it's just a toe. Tape it up. You don't need to see a doctor". Another friend, and EMT echoed this advice. So I sucked it up, bought some Tevas in Kona, and hobbled all over the Big Island for a week. It was a difficult week to say the least. Who knew that big toes were such a big deal?


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## Sea Six (Aug 15, 2013)

klpca said:


> Any idea why I have been referred to an orthopedic surgeon? Is that the same as an orthopedist?



Amazing.  Why ask the doctor you were face-to-face with when you can come to TUG and get all kinds of really neat personal opinions?


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## klpca (Aug 15, 2013)

Sea Six said:


> Amazing.  Why ask the doctor you were face-to-face with when you can come to TUG and get all kinds of really neat personal opinions?



Because it was the middle of the night. TUG was open, doctor's office was not.


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## Pat H (Aug 15, 2013)

Sea Six said:


> Amazing.  Why ask the doctor you were face-to-face with when you can come to TUG and get all kinds of really neat personal opinions?





klpca said:


> Because it was the middle of the night. TUG was open, doctor's office was not.



Because Tuggers are our friends and don't try to make us feel stupid when we ask questions. At least most Tuggers don't.

Good luck with the toe.


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## DaveNV (Aug 15, 2013)

It may be that the way the previous (untreated) break healed complicates proper healing of this new break. Seeing an Ortho doctor will make sure all the issues are known, and can be properly addressed.

If nothing else, at least YOU'D know all the issues are on the table. Big toes have much to do with balance and walking. I'd want to make sure mine worked right, especially after breaking one twice.  

Dave


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## Patri (Aug 15, 2013)

I know plenty of people who don't see a dr. for a broken toe, but it is probably the smaller ones. The big one would be nasty. Good luck. Hope you recover quickly. And why is your lifestyle so dangerous?


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## klpca (Aug 15, 2013)

Patri said:


> ...And why is your lifestyle so dangerous?



This break happened while I was _skipping_ with the kids I was babysitting, lol. I felt like an idiot when the doctor asked me how it happened.


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## Rose Pink (Aug 15, 2013)

klpca said:


> This break happened while I was _skipping_ with the kids I was babysitting, lol. I felt like an idiot when the doctor asked me how it happened.


Why feel like an idiot? You were enjoying life! I love that you were skipping with the kids.   Not happy that you got injured but glad you were having fun.


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## Sea Six (Aug 15, 2013)

klpca said:


> Because it was the middle of the night. TUG was open, doctor's office was not.



Didn't you say the doctor referred you a surgeon?  Your post was after you were at the doctor, who took X-rays and put you in the boot.  Now you make it sound like you posted here before you went to the doctor because TUG was open.  Doesn't make sense why you didn't bring it up then or didn't you think of it at the time?  Just curious.


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## klpca (Aug 15, 2013)

Sea Six said:


> Didn't you say the doctor referred you a surgeon?  Your post was after you were at the doctor, who took X-rays and put you in the boot.  Now you make it sound like you posted here before you went to the doctor because TUG was open.  Doesn't make sense why you didn't bring it up then or didn't you think of it at the time?  Just curious.



The internet does make things confusing.  The doctor didn't think it was broken but ordered xrays just in case. I left the office hobbling on my own. That was Tuesday. Then I got an email on Wed. telling me that it was broken and that I had a referral to the orthopedic surgeon. The office didn't call to set up the appointment until late yesterday afternoon. The woman I spoke with was not a nurse so she couldn't tell me anything. She did seem surprised that I wasn't in a boot. I had a boot at home so I put that on last night after work. What a difference! 

I would have discussed it with my doctor but he didn't think it was broken so I figured it wasn't. I was hoping that someone on tug would know why I would be referred to a surgeon because I wanted to understand if surgeon's offer treatment other than surgery.  Just curious. 

And that's the whole story!


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## sun&fun (Aug 15, 2013)

I recently broke my arm. Minor fracture of the radius just below the elbow. The emergency room dr. ordered x-rays and put me in a splint with a referral to an orthopedic surgeon. The orthopedic surgeon confirmed the break and gave me instructions and prognosis, but never whipped out his scalpel.


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## rapmarks (Aug 15, 2013)

I have had many broken toes, and an ortho doesn't always do surgery, they never have for my toes, and I have had some ugly breaks.  In fact, last break, ortho said "feet don't like surgery" .   Not to open a kettle of worms, but podiatrists have always recommended surgery to me, and i never had it, and I am none the worse for wear. In fact I double checked with an ortho each time, and they said no.
perhaps your dr. is just being careful or covering his you know what.


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## klpca (Aug 15, 2013)

That's good to hear. Hopefully the Dr. will just say keep it in the boot for a few weeks. Of course, I'll know for sure on Tuesday.


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## presley (Aug 15, 2013)

rapmarks said:


> perhaps your dr. is just being careful or covering his you know what.


That's what I think, too.  It probably has to do with insurance and liability.

A friend of mine had a child break an arm on a weekend.  The urgent care doctor said it broken and said to call the orthopedic on Monday.  They didn't set the break or anything.


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## x3 skier (Aug 15, 2013)

IMHO, it's could be all about Malpractice lawyers. If the GP didn't refer you to an Orthopod and your toe fell off or turned into a turnip, some enterprising ambulance chaser would importune you to sue the GP. 

Generally the Orthopod will confirm the diagnosis and treatment but may decide additional treatments are appropriate. At least that's what has happened to my many tears and breaks from baseball to ski racing. What the first EMT/GP/ER folks think has been the same as the Orthopod. Leave it alone or operate has been the initial call and almost always verified by the specialist.  

If it were me, I would see the Orthopod but then I have good insurance. 

Cheers


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## Passepartout (Aug 15, 2013)

Waiting like, 5 days to see the orthodoc after a confirmed bone break sure seems lengthy to me. If I had one of those, I'd want to see the doc in like 5 MINUTES!

Jim


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## vacationhopeful (Aug 15, 2013)

sptung said:


> Well... someone I know had an old toe injury and hurt it again and he took too long to see a doctor.  The surgeon told him the toe had died and the surgeon chopped off quite a bit more than the 1 toe,... still in the hospital as he now has an infection.  If this does not scare you then I don't know what will...



Things like this happen more than people want to talk about. If it happened to you, would you ADMIT how big of an IDIOT you were? Denial is a serious issue in medicine.


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## MuranoJo (Aug 16, 2013)

Passepartout said:


> Waiting like, 5 days to see the orthodoc after a confirmed bone break sure seems lengthy to me. If I had one of those, I'd want to see the doc in like 5 MINUTES!
> 
> Jim



Yeah, I think your bones start to try to heal right away, so if you let it go very long, they'd have to basically break & re-set them.

I had a broken toe which I investigated at a doc-in-a-box the next morning and they wouldn't set it. Instead sent me to a specialist the next week and of course there was nothing they could do then.  And the walk-in clinic told me I'd probably have trouble w/it in later years.  Great.


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## SDKath (Aug 16, 2013)

klpca said:


> The internet does make things confusing.  The doctor didn't think it was broken but ordered xrays just in case. I left the office hobbling on my own. That was Tuesday. Then I got an email on Wed. telling me that it was broken and that I had a referral to the orthopedic surgeon. The office didn't call to set up the appointment until late yesterday afternoon. The woman I spoke with was not a nurse so she couldn't tell me anything. She did seem surprised that I wasn't in a boot. I had a boot at home so I put that on last night after work. What a difference!
> 
> I would have discussed it with my doctor but he didn't think it was broken so I figured it wasn't. I was hoping that someone on tug would know why I would be referred to a surgeon because I wanted to understand if surgeon's offer treatment other than surgery.  Just curious.
> 
> And that's the whole story!



Orthopedic surgeons deal with broken bones.  And joint pains, and arthritis, and injections, etc.  I think your confusion comes from the "surgeon" title but really, they are just bone doctors.  They are not asking you to have surgery.  They probably want to assure that your toe is set correctly so your arthritis doesn't become crippling in future years.  

Surgery is about 10% of what orthopods do... the rest is helping people (like you right now) avoid pain in the future.


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## klpca (Aug 16, 2013)

SDKath said:


> Orthopedic surgeons deal with broken bones.  And joint pains, and arthritis, and injections, etc.  I think your confusion comes from the "surgeon" title but really, they are just bone doctors.  They are not asking you to have surgery.  They probably want to assure that your toe is set correctly so your arthritis doesn't become crippling in future years.
> 
> Surgery is about 10% of what orthopods do... the rest is helping people (like you right now) avoid pain in the future.



Thanks for the info. 

Who knew a toe thread could generate such interest?


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## Bill4728 (Aug 16, 2013)

> Waiting like, 5 days to see the orthodoc after a confirmed bone break sure seems lengthy to me. If I had one of those, I'd want to see the doc in like 5 MINUTES!
> 
> Jim


Most of the time with broken bones there is several days of significant swelling. For a cast to fit right it needs be put on after the swelling goes down. Therefore 3-5 days till you see the ortho doc.
OR put a cast on right away but then have it removed and a new one put on in a week.


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## amycurl (Aug 16, 2013)

My DD (aged 5 at the time) broke her right leg ice skating in Jan 2012; it was fairly late on a Friday night. She cried for about 30 minutes, there was no swelling, and we were able to get her to sleep. The next morning, however, she couldn't put weight on it, so we took her to urgent care right when they opened Saturday.  There was still no swelling, and she wasn't complaining of any pain (except when she tried to put weight on it.)

The docs were surprised as we were when the x-rays came back with the break (nice and clean, too.) Luckily, the doc on duty was board certified in sports medicine, called the ortho doc on call at the hospital, and e-mailed him the x-rays. They both agreed that just splinting the leg would work until Alexa could get seen by one of the main ortho practices in town, which I think happened either that Monday or Tuesday. They are the ones that set the leg in a cast. 

So, the timeline doesn't look unreasonable to me. And both my DD experience and my own when I broke my wrist about a decade ago seems to speak that it is standard practice to heavily splint the broken bone for 2-5 days before setting it in a cast.

Good luck! I can't imagine how much it must have hurt without the boot!


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## PigsDad (Aug 16, 2013)

My experience is that it is SOP for doctors in emergency / urgent care facilities to not set broken bones.  They simply stabilize the patient and splint if necessary, and then refer you to a specialist.  That may be several days later, as others have indicated.

Kurt


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## jlr10 (Aug 16, 2013)

I broke a leg on Kauai 2 years ago, but thought I sprained my ankle.  After a week of it not getting better I went the doctor on call in the Hilton. He took an xray and when he put it on the light board even I could tell just by looking that it was broken.  He told me to see the ortho doctor to see if it needed to be pinned, which I did the next day. The ortho doctor said it didn't, but surprised (as was I) that the original doctor just put an ace bandage on my leg and gave me Vicadin.  I guess he thought if I could walk on it for a week what was another day?  I took 5 weeks in a hard cast and 5 weeks in a soft cast before the bone healed. I always wondered if it was due to week of walking on it without treatment that took it so long to heal.

By the way the ortho doctor said I was referred to see if it needed to be pinned as they were concerned that I might develop arthritis in the join later.  But he said that since I was over 50 I would have developed it my now.


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## SDKath (Aug 17, 2013)

klpca said:


> Thanks for the info.
> 
> Who knew a toe thread could generate such interest?



I always wondered that about the darn gall bladder but there are surgeons and GI docs who spend their lives dealing with this completely useless sac of bile.


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