What problems can happen to the small toes?

There are 3 main problems that can happen to the small toes.

• Deformity — Change in the shape of a toe.
• Pain in your toe joints.
• Metatarsalgia — Pain in the ball of your foot.

Toe deformities, such as claw toe and hammer toe, happen when the tendons that move your toes get too tight or out of balance. The toe can rub on other toes and on the inside of your shoe, causing pressure and pain.

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

What are the benefits of surgery?

Your toes should be straighter, so your foot should fit more comfortably in a normal shoe.

Are there any alternatives to surgery?

Putting padding between your toes and strapping them in place can help give you relief from the pain caused by your toes rubbing.

Using soft shoes from a good-quality shoe shop may be enough. If not, the orthotics (surgical appliances) department at the hospital will be able to give you advice about insoles or special shoes.

What does the operation involve?

Various anaesthetic techniques are possible.

The operation usually takes 15 minutes to an hour.

Your surgeon will discuss with you which of the following procedures the operation is likely to involve.

• releasing or lengthening tendons
• putting joints back into place
• straightening a toe by removing some bone
• stiffening one of your toe joints (arthrodesis)
• cutting and realigning the bones of your toes

How can I prepare myself for the operation?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health. Nicotine is known to prevent bones from healing.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

Some complications can be serious and can even cause death.

General complications of any operation

• bleeding
• infection of the surgical site (wound)
• allergic reaction to the equipment, materials or medication
• difficulty passing urine
• blood clot in your leg
• blood clot in your lung
• chest infection

Specific complications of this operation

• damage to nerves
• damage to blood vessels
• infection in your toe
• problems with bone healing
• loss of movement in your toes
• severe pain, stiffness and loss of use of your foot
• pain in the ball of your foot
• the deformity coming back

Consequences of this procedure

• pain
• unsightly scarring of your skin

How soon will I recover?

You should be able to go home the same day or the day after.

Spend most of the time during the first week with your leg raised so that the swelling settles.

After that, you can usually start to be a little more active.

It can take 6 weeks or longer before the swelling has gone down enough for you to wear a normal soft shoe.

The healthcare team will tell you when you can return to normal activities. Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

The swelling often takes up to 6 months to go down completely.

Summary

If you have problems with your small toes that are causing pressure and pain, surgery should straighten your toes and make your foot fit more comfortably into a normal shoe.

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