Lesser Toe Deformities

Common conditions

• Hammer toe

• Mallet toe

• Claw toe

Who does it affect?

Lesser toe deformities are a very common condition, increasing in incidence with
increasing age. Females tend to be more often affected than males. 

Why does this occur? 

There are many factors which can contribute to formation of lesser toe deformities. It may be because the joints are weak (if they have been damaged by injury or arthritis), if the muscles that control them become unbalanced or if pressure at the toes becomes too strong (constrictive footwear, too high a heel). Other rare causes include systemic diseases such as rheumatoid arthritis, diabetes or neuromuscular disease. Similarly one toe may be naturally longer than the other (often the 2nd toe) or one toe may be shorter than the adjacent (shortened by surgery or injury).

Symptoms

Well localised pain due to rubbing on shoes causing corns and callosities. Often pain develops in the ball of the foot (metatarsalgia). Bent toes may rub on adjacent toes causing pressure symptoms.

Investigations

Full clinical examination would be required. X-rays would be required to identify any associated arthritis.

Non-operative treatment

Non-operative treatment consists of fitting patients into adaptive shoewear with soft leather uppers and a thin full length insole. Local chiropody treatment to any associated corn +/- strapping of the toes.

Operative treatment

Operative treatment is only required if symptoms from the toes are interfering with daily activities and the problem is not helped by the simple measures outlined above. Surgery is performed to straighten the toes. Surgery can be performed under general anaesthetic, regional anaesthesia (only the leg made numb) or in some circumstances local anaesthesia (only the specific part of the foot being operated on made numb). There are a number of different operations which can be used, depending on the shape of your toes and how stiff they are. Often wires will be used to maintain the surgically corrected position and will be left sticking out of the tips of the toes, usually for a period of four weeks. No plaster post-operatively would be required & patients would be allowed to fully weight bear on their foot immediately after surgery.