What is it? 

The lesser toes are those toes other than your big toe. They can suffer from a range of deformities which can affect their position and make the toe more likely to be affected by other complications. These deformities affect each of the three bones in the toe which should lie in a straight line. The most common deformities are:

Claw toe: This is caused by one of the tendons in the foot contracting, raising the first bone and making the second bone of the toe point downwards.

Hammer toe: This is caused by one of the tendons in the foot contracting. When this happens the first bone in the toe is slightly raised, the second toe tilts downwards and the bone at the tip of the toe is almost flat.

Mallet toe: This is caused by one of the tendons in the foot contracting which point the tip of the toe downwards while the other two bones are slightly raised.

Diagnosis and treatment options

Your consultant will examine you and ask you to demonstrate certain movements to check how well your foot is working. You might need some additional tests:

• X-ray
• Ultrasound
• Magnetic resonance imaging (MRI) scan

Each deformity is diagnosed by a range of indicators such as flexibility, stability, and sensation as well as swelling, calluses, and redness. Your consultant may also take an X-ray of your foot.

Lesser toe deformities tend to require surgery. The surgery is a minor procedure which releases the trapped soft tissue and lengthens the tendon. Fusion may also be required for more severe deformities which involve the consultant removing the cartilage from the end of the toe bones in the middle joint. A removable pin is inserted to hold the two ends of the bone together so that the bones fuse.

The surgical procedure is performed under a general anaesthetic and is performed as a day case. Recovery is dependent upon the underlying problem being addressed but if a removable pin is required, this is usually in for between four to six weeks and the foot is generally in dressing support for this period.