To not take son to a&e with a suspected broken toe?

[Pawprintsonthewindow]

Ds was at a presentation today in a lovely social club. He leant on a tabletop which wasn't attached to the legs of the table and it fell off onto his foot. It's landed near the top of his little toe and the two next to which are now pretty bruised.
He's not bothered by it much but it is sore. He can wiggle all his toes and walk on his foot. He's had calpol and is being careful with it.
I'm not sure if it warrants a trip to a&e. Our local hospital doesn't have an a&e and I don't think the walk in centre will deal with broken digits.
The nearest a&e is half an hour away in a big town. I could ring 111 but every time I have used them in the past they just tell me to use a&e.
What would you do?

you can actually splint them. it doesnt look dislocated but you can splint them using ice lolly sticks between each toe. ice lolly sticks can be wrapped up with one layer of bandage and put between the first good toe and the first bruised toe and again the first bruised toe and the second bruised baby toe. wrap in all in a bandage and rest for a couple of days.

My youngest broke his toe (2nd) a few weeks ago. We went to UTC as he was complaining of pain and it was very swollen. The Dr had a feel abd said it was definitely fractured, we had to go back the next day for an x-ray; however the dept refused to do it because they can't do anything for broken toes (unless it's a big one).

When I broke mine they gave me breathing exercises to do, which are important.

I broke my toes twice and looked like in your son's pic. I also could walk and move the toes. You DO need to go to either A&E or Urgent care centre to get it xrayed. If it's misaligned (without an X-ray you won't see it) it might need repositioning. In any case, they will need to show you how to tape it and might give him a special boot to walk. Otherwise it won't heal properly and your son might have pain there for years. Definitely not worth the risk. Especially for a child.

If you're pondering a toe fracture the official nhs advice is don't goto hospital in most circumstance and is written as such here:
https://www.nhs.uk/conditions/broken-toe/

It's the same as a simple rib fracture they don't require any treatment so little point in exposing to radiation when the plan of 'self care advice given - RICE and otc analgesia as required' will be given regardless of whether there's a fracture or not.

If you think there could be a fracture of a bone in the foot however it's worth presenting to be checked. Signs that would make me concerned about this would be lots of pain from the foot itself, or if when you press on the bones of the foot it's particularly tender.

they will literally tape it up anyhow

id go the walk in tomorrow for a child not a n e!

• please dont go a and e for a possible broken toe!!

ive done 2x of mine and all you can do is tape them up

I would go to a minor injuries place if you have one or get a nurse appointment at the GP, if they then send him for an X-ray then you will know it's more needed. Hope he has some big comfy shoes to wear.

That does look broken. I'd still be tempted to go to the walk in if possible though as my dad broke his toe and my mum and I said he didn't need to go and get it seen as they wouldn't do anything. Still hurt months later and he went to Dr's about it. Turns out it wasn't broken - it was dislocated and because he didn't get it seen to earlier, it had fused and he needed an operation to get it fixed. Of course we don't live it down but I do now confirm any broken appendages now just in case!

Do NOT do this.

I'd agree with others saying the location of the bruising is more on the metatarsals, which would need treatment if broken. No harm in seeing how it is in the morning especially as he'll just be sleeping on it between now and then. But if in any doubt I'd be going in.

In the morning, have a gentle press around his toes and foot bones. If it hurts on his actual foot just below the toes, rather than the toes themselves, I'd want that checking.

I would get it checked to confirm if it's broken, which will be helpful in terms of understanding recovery time / PE etc.

In my experience the splinting to the next toe only works when it's a (single) middle one that's been broken.

As a veteran of many toe breaks the best thing you can do is put him in supportive socks (ie stretchy rather than cotton), and into supportive trainers. And no running around for a week or so.

They tend to heal very quickly!

I’ve broken my big toe before. Twice. Same place! If it’s a clean break they don’t do anything at all now, just tell you to use pain relief and take it easy for the next 6 weeks or so. Only advice is to elevate it

I broke mine last year, went to the minor injuries drop in, but they were closed.

So was sent to A&E where they triaged me, said it was probably broken and said they’d see me but couldn’t really do anything and I’d have to wait.

I decided not to and it healed with time and being careful.

I had similar bruising to your son a few years ago. I was sent to A&E by the walk in centre who said that I'd damaged bones further up the foot and needed an X-ray to see how far I was injured. It turned out to be bruised bones. I was walking with a stick for a while and it took months to heal. Would get it checked out as it was definitely worse than "just" a broken toe.

DD bruised her toe aged 14 showing me how she swooped in a netball match. It was bruised but she could walk. I didn’t want to bother A&E. it healed bent. Went to gp who referred to Orthapaedics and yea it had been broken and we should have gone and got it strapped. She’s now 23 with a bent toe and I feel terrible.

Call 111 or just go to a UTC (not a&e) or alternatively gp on Monday/xray.
(111 are great BUT if they’re going to call you back at 2am for this it’s a bit of a disruption to sleep).
My 3y/o just broke his big toe in a similar way to your son (fell off the chair he was sitting on 🙄).
111 suggested xray but I called them at 8pm and they called back at 2am and suggested attending within 12 hours and said definitely don’t wake him up for it (he was in more pain). So no rush.
They suggested going to get an X-ray and the doc also prescribed prophylactic antibiotics for osteomyelitis which is apparently common in lower limb breaks in children but I’m not sure if that’s because the skin was slightly broken and there’s a blood blister under the nail.

Anyway - GP may have arrangement at local hospital to xray. Or if not UTC go at quiet time. We went mid morning and were in and out in about 2 hrs Inc xray and strapping. They they referred to virtual fracture clinic.

I would get it checked out. It might be absolutely fine but it's best to be sure as you don't always know what's going on. I have broken my toe in exactly the same way. Children's bones thankfully heal much quicker but they also hide pain. My friends daughter was hanging from monkey bars with a broken wrist 🙈 I would keep it elevated, take to minor injuries when they are open and avoid any tight footwear to prevent any swelling. Hope he's ok :)

i am surprised you did not take him immediately.
esp with a child.
half an hour away is nothing.

Definitely minor injuries. He's 8 and he's still growing. Don't waste GP nurse appts. They don't have X-ray equipment. Do the right thing and get it checked it out. This is not the time for guesswork and hoping it will get better on its own.

Good to hear your son feels okay. Toes generally aren't x-ray's unless dislocated, the bruised toes here do not look dislocated. A boot and crutches wouldn't typically be given.

See Patient information leaflets\Toe fracture or dislocation – discharge advice, in the link below. It's the same advice whether the toe is bruised or broken.
https://www.royalfree.nhs.uk/services/trauma-and-orthopaedics#patient-information-leaflets

Looks like a bruised foot. In isolation (without pics) of his other foot you can't see if his toes are a different shape or there is swelling but it looks fine to me to be honest.

You need to take him to get checked out (maybe at a walk-in minor injuries unit). This happened to us last year with my daughter - when I looked into it online (NHS website), the advice for children with a possible broken toe was definitely to get it seen to / x-rayed. We went to a minor injuries unit, had it x-rayed, it had broken, and they gave us advice on what to do (and what she couldn’t do until it had healed).

No swelling at all. The bruising doesn't look as bad now but I will reassess in the morning. The divide between yes and no is literally like the inside of my mind!

Did you get him checked?

Hi, sorry I'm in work so haven't been back on to update.
It was sore this morning but less bruised. He was walking on it but it was causing him a fair amount of pain and he agreed with Dh when he said he wouldn't be able to go to his friends ninja warrior party.
Dh took him to the walk in centre who x rayed it and said it wasn't broken. Then another doctor looked at it and said he thought he had fractured three bones in his foot. They sent the scans over to the local hospital to look at and mentioned him having to have a boot and something about tendons.
In the end the next doctor decided that it wasn't a fracture so just keep going with the calpol and for him to rest it.
Thanks for all the replies.