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