Toe Shortening Surgery

This is one of the most commonly undertaken procedures in our practice and was pioneered in the UK by our specialist lead Consultant. These patients usually suffer with toes which are disproportionately over long, complain they cause rubbing in shoes and have real difficulty finding shoes to fit comfortably as well as the aesthetic appearance. Commonly it is the 2nd and 3rd toes which are longer than the big toe and this affects men as well as women.

As well as causing some people embarrassment because they dislike the way their feet look, longer toes also commonly cause discomfort. As a consequence of not being able to find shoes which fit properly the toes compensate by clawing to keep the shoes in place. This can then cause painful corns and lumps underneath the skin called bursitis, which form over the small knuckles of the toes.

We also perform toe-shortening (and foot narrowing) surgery for our trans-woman community, who frequently struggle to be able to buy or fit into a larger female shoe-size.

The Procedure

For the middle toes, the procedures involved in toe shortening are done by removing bone from the toe/s to effect the desired toe shortening. For milder shortening requirements our arthroplasty procedure involves removing a small section of bone from one or other of the two toe joints in the long toes. For more aggressive toe shortening requirements we use a fusion (arthrodesis) procedure, requiring two pins which stay in the toes for 4-6 weeks. Walker boots are required to be worn until the pins are removed (a simple and quick procedure performed in the outpatient setting).

For the big toes, we remove a section of bone from the base of the big toe and re-fix the bone with a small bone screw. This leaves the joints unaffected and free to move as big toe function is more important.

We always aim to achieve the classic “staircase” stepdown to the toes; making shoe-fitting much easier. The consultation will cover the condition, how toe shortening surgery is undertaken, rehabilitation, post-surgical recovery requirements and the risks of the surgery. Further x-rays or scans maybe required.