Toe Deformities

There are a few common toe deformities, which we regularly correct at our centre. These include hammertoes, mallet toes, clawed toes, retracted toes and curved toes (clinodactyly). Less commonly we see short toes, termed brachydactyly. Many of these can be easily and safely corrected as day-case procedures usually under local anaesthetic with minimum time off work for recovery (around two weeks is required, but of course working from home is permitted).

Our emphasis is on good aesthetic and cosmetic foot surgery results, which we believe has been missing in surgical foot operations. Our consultant has over 30 years surgical experience having corrected many thousands of toe deformities. The consultation will cover the condition, how the correction is undertaken, rehabilitation, post-surgical recovery requirements and the risks of the surgery. Further x-rays or scans maybe required.

Hammertoe

Probably the most common deformity of the toe where the middle joint is bent and the knuckle rubs in shoes.

Surgery

It is important to make the toe stable and straight. We use either arthroplasty or fusion for these corrections. We will always remove any lesion such as a corn or depigmented shoe-rub lesion.

Mallet Toe

Mallet toe this is when the end joint is bent and deforms the toe. The are normally easily corrected by arthroplasty. We will always remove any lesion such as a corn or depigmented shoe-rub lesion.

What is an arthroplasty?

A small piece of bone is removed from one side of the joint (arthroplasty) which allows the toe to straighten. Any unsightly rub lesions e.g. corn is removed at the same time. No metalwork is used for this procedure.

Long Toes

Long toes (for the second toe also known as Morton's Toe). For many patients, especially female, overlong 2nd or middle toes causes shoe fitting problems as it is difficult to fit this shape of foot into modern fashionable shoes.

Surgery

For mild toe shortening, the arthroplasty can be used on either of the two toe joints. If more shortening is required then more bone needs to be removed. The bones will need to be fixed back together requiring pins for several weeks. This is termed an arthrodesis or fusion.

Curved Toes

Clinodactyly or curved toes are when the middle or end joint of the toe forms an angle This is a joint deformity where the end joint of the toe is angulated instead of being straight. This is corrected by similar surgery to the mallet toe (arthroplasty).

Why surgery?

None of the above deformities can be corrected by conservative (non-surgical) methods, although using toe protector devices, padding and accommodative footwear may help. Although surgery carries risks (which will be discussed and written information provided); it is the only treatment that can provide a cure for the above deformities. Some of the above will also worsen over time (especially hammer and mallet toes). Most of the surgery above has a success rate of approximately 95%, although de-syndactyly is 100% successful in our practice. Surgery can fail, and sometimes revision (repeat) surgery is necessary.

How is the surgery undertaken?

All of the above surgery, can be undertaken under a local anaesthetic (awake surgery) or a general anaesthetic (surgery whilst asleep). Most patients will be able to have this as a day case surgery with recovery at home. For local anaesthetic (awake surgery), we can provide a pre-med sedative if required.

Aftercare appointments will be scheduled to check progress, give wound care, remove stitches, give advice on shoes and mobilisation and take x-rays etc. where necessary. Most patients can get into roomy footwear within a couple of weeks of surgery but some procedures require patients to wear a walker-boot for several weeks.

Return to work

Obviously this is dependent on the type of work you do. Many patients can and do work from home. If you have a reasonably sedentary (e.g. desk) job then you may only require two weeks off work although overall recovery takes several months.

Exercise

We allow patients to swim after 4 weeks and driving from 2-4 weeks for most procedures. Upper body work at the gym after 2 weeks can be undertaken. Low impact cardio such as cross-trainer, cycling, rowing is allowed from 6 weeks and running after 10 weeks is permitted. These periods may be extended if surgical complications occur.