When the toe is hit by a heavy object, whether or not there is a fracture, strict local braking is required to prevent further aggravation of the injury. The affected limb should be elevated and a cold compress should be applied to reduce the swelling and the exudation of fluid between the tissues, which will also reduce the pain level rapidly. In addition, you should be transported to the hospital for an X-ray examination to determine if there is a fracture of the toe when available. If the injury is simply a closed toe, only cold compresses and analgesic treatment are needed. If it is an open toe injury, you will also need to decide whether to debride and dress the wound or debride and suture it, depending on the size of the wound.