Thanks for much for the response!

So, are my capillaries malfunctioning? Most people seem to have issues with cold, rather than heat but nerve damage just means the nerves react the wrong way right in any direction?

I think the reason my toe stayed normal for a whole day with proper skin tone and minimal swelling is because I kept it really cool the whole time, and only had mild showers to stop the trigger. Do you think I should avoid contrast baths at this stage? Sometimes when I wake up and take off the tape, the skin switches to normal skin color, and then the baths make it go red and swell a bit again - not sure if I'm better off doing the baths to keep the blood flow higher, or just work to minimize the swelling - maybe it's a catch22!

I actually ordered some Epsom IT lotion yesterday on your recommendation so thanks for that - I'll give it a try. Sometimes, it can feel raw, red, itchy and hopefully the cream helps with that.

Honestly, I don't experience much pain with it when I keep it cool and don't walk too much. In fact, I never had bad pain which is strange - and I'm guessing this was because I destroyed the nerves. I still cycle 6 miles a day without pain (some niggling, tingling) but even that has subsided a bit - it probably is because it's freezing cold outside

Do you think those patches could help if I wanted to go out for a few drinks, because I know it will flare up and burn?

The patches are for inflammation. When you injure tissue, that releases cytokines (inflammation chemicals)...which in the short run work well, but in the long run can keep inflammation working when it is no longer needed.

By turning off these chemicals with the Salonpas, then inflammation goes down, redness goes down, and pain goes down.

The Morton's or your Epsom IT is more for circulation. If your skin is really broken or irritated, the magnesium lotions may sting.
Use them then, slightly away from the toe skin, more toward the top of the foot area.

There is fascia in the foot, tendons, besides the bones, and any or all of them could have been injured. If you feel pain, your nerves are not dead, but just reacting to it all.

Using topical things on the foot, should be tried first, rather than drugs. Sometimes these topicals are better than oral things because they fix the blood flow which may be messed up and not let things in the blood to heal thru to the toe damage.

Ice always feels better on an injury. And also nerve injuries like ice better than heat. You can try ice packs on your foot 2 or 3 times a day and see if that speeds things along too. Since cold feels better, try that. Don't over do, and max of 20 minutes at a time.

Interesting, so I might still have repairing soft tissue damage and the neuropathy is just a manifestation of that? i.e. it might not just be chronic neuropathy at this stage - I guess it's too early to tell.

I know the bone didn't union properly either at the time - it's an awkward spot to immobilize.

My podiatrist recommended Neuro-Eze, but I could only find it online and my instinct tells me it's a bit of a scam but I could be wrong - it is supposed to improve oxygen using L-Arginine but I don't even know if that is permeable through skin.

I will probably continue to ice it. It definitely give some relief when it swells or burns. Do you think I should just leave out the heat bath then? And should I ice it even if it's not swollen when I wake up?

I'd only ice it if it hurts.

Are you really tall? I suspect from your photos that you are. If so it is a LONG way to that pinkey!

Arginine is in some diabetic foot creams to increase circulation.

The Magnesium lotions do the same thing. So I'd start there. Magnesium also blocks the NMDA pain receptors, so it is more useful than arginine.

You could combine the heat treatments followed by ice... see how that goes. Don't over use cold though, as that constricts blood flow.

Think about how your hands feel in the snow without gloves. Then you come in and warm them up.... and they get red and tingle and burn! Same thing with that pinkey. If it hurts at bedtime do the cold treatment then. You will not be standing up and the blood flow with return to normal quickly, when you are sleeping.

Injuries can take a while to heal. Give it time. Don't worry about neuropathy at this point. You just have a trauma toe.
I'd take some vit C daily.... 500mg for about 2 months. Also so other antioxidants, if you want. Some people develop RSD from injuries or surgery or trauma to the ankles/feet and wrists. Vit C seems to block this potential. Since you are taking a while to heal you will want to prevent RSD.

RSD patients however do hate cold treatments, and prefer heat, so you are still the reverse of that. RSD may become permanent, but studies in Europe show Vit C prevent that for many patients.

Keep your foot elevated when you can, at home, etc. I had a surgery on my foot when I was 12, on the instep and it took over a year to heal. Foot injuries take time.

I was thinking about this, but I'm wondering if:
a. The circulation is just bad in general (like cold ears/hands), and the heat is actually helping by increasing the blood flow?
OR
b. The circulation is normal, but the damages nerves are overcompensating by dilating the vessels too much and allowing too much blood in (and therefore swelling)?

It's funny you say that because my podiatrist said almost the opposite Well, he said, don't worry about the hairline fracture and focus on the neuropathy.

Actually, I should mention that right after that visit (4.5 months after injury) I started putting weight back on the foot, did one contrast bath and the toe came alive - burned really bad all night long - I interpreted this as a good thing though - that maybe I had them firing again - not sure if it was the weight bearing or contrast baths that did this though. It was only for one night though, it died down over the next few nights.

Taping that toe tightly to the others is going to reduce circulation to it.

I have broken sesamoid bones in both feet...they have never grown back together. I have to wonder if the really small bones just have a lower potential for repair?

I looked up your pinky healing rate, and many sites suggest another opinion, after 6 wks if healing is delayed.

You might consider that.

If your toe does not throb in the night, consider that a plus.

My toe only throbs when I remove the tape, and it's hot - it throbs due to the swelling which can make the toe hard and the skin a bit shiny even.

Right now, I'm only using the Epsom lotion like you recommended, without any tape. It's swollen for sure, but more a purplish color. I'm going back to the podiatrist next week to ask about the bone. I'm not sure why he was so certain I should ignore the bone and it was fine after looking at the xray.

I never took any B12 supplement, just Calcium and Vit C. Since my neuropathy is trauma induced, it's less likely to be a deficiency I guess.