Lesser Toe Deformity
Our feet are split into the forefoot, midfoot, and hindfoot. Your forefoot has four (4) small toes, and they are called phalanges. With one (1) large toe named the hallux. Your phalanges are made up of three (3) bones and three (3) joints. Your big toe is comprised of two (2) bones and two (2) joints. Your midfoot and hindfoot are structurally different and are responsible for bearing body weight when you walk and run.
What causes toe deformities?
Toe deformities often are congenital and occur later in life, usually from wearing ill-fitting shoes like high heels. There are diseases like diabetes, stroke, arthritis, rheumatoid arthritis that impact the nerves and muscles of your ligaments and tendons in the toes. They cause tightening and result in these toe deformities. In other cases, fractures, blunt trauma, accidents, or injury lead to deformities of the toe.
Different Types of Toe Deformities
Hammertoe deformity is the most common deformity of the lesser toes. The structural issue is a continual, ongoing imbalance of extension and forces between the lesser toes. The imbalances forces involve the extrinsic and intrinsic foot tendons.
Bunions are bony bumps forming on the joints found on the base of your big toe. They form when your big toe begins to push next to the next toe, which forces that joint to become bigger and protrude outward. Often, the skin over the bunion becomes red and very sore.
Claw Toe affects your four smaller toes all at the same time. Your toes bend up at the joint where the toes and your foot meet. They bend down in the middle joints and at the bones near the very tip of the toes. The claw formation makes your toes curl in a downward position to the floor.
Mallet Toe bends down at the joint which is closest to the tip of the toe. It usually affects the second toe but often happens in the other toes as well.
Non-Surgical Treatment Options
- Toe Spacers
- Metatarsal Pads
- Orthotics Devices
- Shoe Modification
Surgery for lesser toe deformities may be necessary when the disabling pain shows no improvement after non-surgical treatment options do not work. These surgical options include:
- PIP Joint Resection Arthroplasty
- Metatarsal Shortening
- Diaphyseal Shortening
- Weil Osteotomy
- MTP Joint Resection Arthroplasty
- Plantar Condylectomy
- MTP Plantar Plate Reconstruction
What To Expect With Recovery.
Generally, lesser toe deformity or hammertoe surgery is an outpatient surgical procedure. Often, patients will experience some swelling for six (6) months to (1) one year. Dr. Stein advises that you may need to wear a custom insert or shoe to help support your toes post-surgery. You will also want to avoid placing weight on your foot for a few weeks after your surgery. Dr. Stein recommends elevating your foot as much as possible to expedite the healing process as well as reducing pain.
You may find walking a bit difficult at the beginning of your recovery. Some patients use a cane or crutches for several weeks to help minimize the weight on their foot. After a few weeks, Dr. Stein removes any stitches or pins from the surgery. Because you are at risk of developing a lesser toe deformity again, Dr. Stein has an exercise program to help prevent it from returning as well as strengthen your toes and help them heal properly.