Fracture or Variation in Distal Phalanx of the First Toe

Abstract

Background:

Variations of the epiphyseal ossification of short tubular bones were repeatedly mistaken for fractures.

Case Study:

The case of an 11–year-old male patient after a minor trauma is presented. An extra ossification center at the epiphysis of the distal phalanx of the first toe was diagnosed as a fracture and treated appropriately. The recovery was very fast, about 4 days. 3 years later the extra ossification center was still visible and a parted epiphysis of the proximal phalanx appeared again like a fracture, but with no clinical symptoms in that region. This time after a minor trauma, there was no treatment and the patient was free of symptoms after 1 week.

Conclusion:

The variation range of the ossification centers of the first toe is wide. In minor trauma X–ray findings should correlate exactly with the symptoms not to overdiagnose toe fractures.