TOE  SHORTENING

ARE LONG SECOND TOES COMMON?

It is very common for people to have second toes which are too long.  You can see in this photograph that the patient has a long second toe.  As a result the long second toe has buckled leading to pressure points over the top of the "knuckle Joint".  The buckled toe has also made the tip of the long second toe painful.  The nail plate has early signs of damage.

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IF I HAVE A LONG SECOND TOE WHAT SHOULD I DO?

If the toe is not painful and does not cause any problems then no treatment is required.  

If, as a result of the long second toe you have pain or problems then really there are only two options:

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• Padding

• Toe-shortening

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TOE SHORTENING

Toe shortening is one of the commonly performed operations in our practice.  With over twenty five years experience in the field of foot surgery painful long second and sometimes third toes remain in the top ten of foot problems we see. Apart from padding the toes the only real long-term solution for long second toes is a simple procedure to shorten the offending toe(s).

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HOW IS THE TOE SHORTENING OPERATION DONE?

A small cut is made over the top of the toe.  If a corn or damaged skin is present this can normally be removed at the same time.

A section of bone is then removed using a specialised bone removing instruments.  Just the right amount of bone is removed to make the toe(s) the right length. The bones are then remodeled into the correct shape. With the toe(s) shortened the bones then need to be held in place.  There are two main ways of doing this.

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• A wire

• Implant

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A wire can be used to temporarily hold the bones, these are normally left in place for 4-6 weeks.  A more recent advance has been the use of specially designed clips to hold the bones in position internally.  Rather than a wire passing through the toe the clip stays inside the bone.  Although this advanced technique has only been available for a few years it is proving to be an effective treatment with quicker recovery and less risk of infection as there is no pin protruding from the toe(s)

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HOW MANY STITCHES WILL I HAVE?

Most patients require only three stitches in each toe which are removed after 10-14 days.

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WHAT ARE THE RISKS OF SURGERY?

All operations carry risks and toe surgery is no different.  Risks include:

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• Infection

• Toe swelling

• Non-union (bones do not knit)

• Recurrence of toe deformity

• Stiffness of the toe

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HOW LONG DOES IT TAKE TO RECOVER AFTER TOE SHORTENING?

• After the toe shortening surgery you are advised to rest and when  walking using crutches is allowed for the first week.

• A surgical shoe is provided and you will need to wear this for two weeks

• At 2-weeks your stitches are normally removed.

• During the first two weeks, in order to minimize swelling, ice packs should be applied and the feet should be elevated as much as possible. 

• You might find swelling persists for 3- 6 months after surgery and you will have to modify your footwear to accommodate this initially.

• Driving is permitted after 2-4 weeks

• We advise the use of various scar-care products, which can be discussed after surgery.

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