Spiral fracture of the proximal phalanx of the middle toe

On first glance, the position appears normal. However, comparing the orientation of the fractured toe with the adjacent toes helps one appreciate the slightly abnormal position. The tip of the third toe lies closer to the fourth toe than to the second due to 5 to 10 degrees of angulation. The middle and distal phalanx of the third toe have a slight "curve" laterally while the second and fourth appear to curve straight down or medially. This suggests 10 to 20 degrees of rotation at the fracture site. Although the angulation and rotation seen in this radiograph are well within the acceptable range, they could be improved by a gentle reduction maneuver before buddy taping to the second toe. Because the tip of the third toe angulates away from the second toe, buddy taping to the second toe would be preferable to taping to the fourth toe.