The stubbed great toe: a cause of occult compound fracture and infection.

Six children suffered Salter I fractures of the distal phalanx of a great toe caused by stubbing. The first four children presented with cellulitis and osteomyelitis. The last two were treated promptly with antibiotics, and no infection developed. Analysis of the anatomic relationship of the distal phalanx and nail indicates that these fractures were compound despite the absence of usual clinical signs. Recognition of these occult compound fractures and treatment with antibiotics should prevent infectious complications.