The UK’s premier Cosmetic Foot Surgery Centre

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. This is undertaken by fusing the middle joint. In our practice we no longer use pins through the toe. We use a special titanium clip (Netxra) which is much easier for patients to manage after surgery and return to normal footwear and work more quickly than traditional methods.

Mallet toe this is when the end joint is bent and deforms the toe.

Surgery

Usually for this deformity 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 (above) is removed at the same time. No metalwork is used for this procedure.

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 toe-shortening surgery, we now use the internal Nextra clip (see x-ray below). This avoids wires sticking through the toe-end for 6-weeks (traditional method). We have found fewer complications and better overall results for patients, over traditional techniques, such as external toe pinning.

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).

This is normally due to soft-tissue contraction which needs to be release and stretched to allow the toe to sit back down.

Joined toes also known as webbed toes or syndactyly which can affect any of the toes. This is a birth (congenital) abnormality, where the toe fail to separate normally intra-uterine.

Surgery

De-syndactyly - surgical separation or toe-splitting surgery - (usually requiring skin graft); can be performed with good results.

Short toes - normally caused by brachymetatarsia - a short metatarsal bone. This condition normally develops and becomes more obvious in the growing foot. It usually affects the 4th toe, although in fact it is the metatarsal bone behind the toe, which is abnormally short.

Surgery

Both of the above conditions were corrected by using a bone graft to extend either the metatarsal or the toe.

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.

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.

Am I covered under insurance?

Many of the above problems are covered by private health insurance, although the general rule is cosmetic procedures are not.