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Surgery for Problems of the Small Toes

This webpage will give you information about surgery for problems of the small toes. If you have any questions, you should ask your GP or other relevant health professional.

What problems can happen to the small toes?

The three main problems that can happen are deformity, pain in the toe joints and metatarsalgia. Toe deformities such as claw toe and hammer toe happen when the tendons that move the toes get too tight, or out of balance. A bunion can cause pressure and pain (see figure 1).

Problems caused by a hammer toe

Figure 1 - Problems caused by a hammer toe

Inflammatory arthritis such as rheumatoid arthritis can damage the toe joints and this may make them come out of position (dislocate).

What are the benefits of surgery?

The main aim of surgery is to straighten your toes and get the front part of your foot taking your weight comfortably.

Are there any alternatives to surgery?

Putting padding between your toes and strapping them in place can help to stop pain caused by the toes rubbing. Custom-made insoles for your shoes will help to take the pressure off any painful areas. Special shoes that are wider and deeper than normal can stop your toes rubbing.

What does the operation involve?

A variety of anaesthetic techniques are possible. The surgery depends on the problem with your toes and may involve releasing or lengthening tendons, putting joints back into place, straightening a toe and changing the shape of a bone. Your surgeon may fix the toes in place with wires or tiny screws.

What complications can happen?

1 General complications of any operation

Pain
Bleeding
Infection in the surgical wound
Unsightly scarring
Blood clots

2 Specific complications of this operation

Difficulty passing urine
Damage to nerves
Damage to blood vessels
Problems with bone healing
Loss of movement in the toes
Recurrent deformity
Severe pain, stiffness and loss of use of the foot (Complex Regional Pain Syndrome)
Pain in the ball of the foot

How soon will I recover?

You should be able to go home the same day or the day after. For the first week, you will need to spend most of the time with your leg lifted up so that the swelling settles. It can take six weeks or longer before the swelling has gone down enough for you to wear a normal soft shoe.

Summary

If you have problems with your small toes that are causing pressure and pain, surgery should straighten your toes and help you to move around more comfortably.