My wife disjointed her pinky toe and it has been suggested that she have a rod surgically implanted in order that it heal properly. Is there any nonsurgical for her toe to heal without leaving her in great pain for the rest of her life?
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I disagree that the initial treatment be surgical. From what you say there are no broken bones which is a benefit and therefore assume that this is a result of torn ligaments from the trauma. Ligaments connect bone to bone and in small toes that do not require fine movements as for example a finger might, one can try conservative care such as splinting the digit. There are many ways to do this but I would recommend having a trained podiatrist do this for you
The posts have covered the options well. It is rare that the small or pinky toe needs to be held after reduction but there are certainly reasons to allow it to heal in the best position. I suggest that you use Coban/Coflex/Medirip. These are self adherent wraps that come in 1" size that fit easily around the small toe and will not give your wife a rash which happens with the use of tape over time. The toe is wrapped usually from between the 4th toe and the pinky toe so you are wrapping the toe from inside out You want to start at the bottom or web area. It will depend on where the fracture or dislocation is how to best wrap the toe since the bone goes back past the web area for about 2 cm+/-. It is always best to ask the doctor treating your wife to advise on how to best apply the wrap. If they do not seem willing to then it is time to go to another podiatrist. Do keep the foot in the surgical or post operative shoe until the pain resolves and the toe is healed. Good Luck with this.
I would agree with my colleagues. Surgery is seldom necessary and if required usually does not require fixation with a pin.
A lot of this depends on how "old" the injury is. If this just happened recently, closed reduction can be attempted. That means numbing the toe, taking an x-ray or fluoroscopy to see the position of the toe, and then the doctor sort of recreates the original injury, pushing it out of place, and then putting back in the best position possible. Most injuries of the little toe heal without surgery. If times goes on, and she is still having pain, surgery can always be done later.
In most cases the toe can be relocated without surgery, through what we call closed reduction. 5th toes often do not need to be perfect since they have little function. If it can not held in place be splinting in rare case a pin may be necessary.
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