Lesser Toe Deformity
The lesser (toes 2-5) can become bent at any of the small joints, causing pain and rubbing on shoes. This is frequently due to other foot conditions causing an imbalance of the muscles that hold the position of the toes.
Hammer toe: bent at the near joint (PIPJ)
Mallet toe: bent at the far joint (DIPJ)
Claw toe: bent at both joints
This is frequently present in conjunction with bunions and metatarsalgia
Figure 1: different possible lesser toe deformities
Treatment options:
Non operative treatment
Modification of shoes and/or padding the affected area
Taping the toes into a more normal position
Operative treatment
The primary goal is to realign the bones to remove the prominence and prevent recurrence. This often necessitates fusion of the small joints of the toes.
In some cases release of the tight tendons of the toe may be all that is required.
Surgeries performed for lesser toe deformity include:
Flexor tenotomies
DMMO (minimally invasive osteotomy)
Every patient’s foot is different and thus your specific case will be assessed and a personalised recommendation will be made.
Figure 2: fusion of the 2nd toe PIP joint (arrow) in conjunction with other forefoot procedures