Lesser Toe Deformity & Forefoot Pain Surgery
Deformities of the lesser toes are common and can be associated with significant pain and discomfort. These deformities in many cases occur over several toes and there are several surgical procedures that can be used to address this.
The goal of surgical treatment is to improve symptoms by restoring alignment and function, and preventing the deformities from re-occurring.
There are four main procedures for performing this surgery and a brief description of each follows…
“Oxford” Procedure
This surgical procedure involves the surgeon making a straight cut is made at the base of the toe. The tendon on the top is lengthened and the joint at the base of the toe is freed up. A small incision is made across the first joint in the toe and a small piece of bone removed from it. The joints and tendons are stitched up and the toe splinted with paper stitches that hold it in the corrected position.
“Stainsby” Procedure
This surgical procedure involves the surgeon making a cut at the base of the toe in the shape of a small chevron. The joint at the base of the toe is freed up, some bone is removed from this joint and the tight ligaments are freed to allow the joint to be corrected. The top and bottom tendons are stitched together and the toe is then stabilised with a pin driven into the tip just below the nail.
The cut is stitched up and dressings applied. There is no need for a plaster.
Fusion of The Lesser Toe
A cut is made across the joint at the end of the toe and a small piece of bone is removed from each bone and as above. The toe is then held straight with either a narrow metal pin through the realigned joint, which protrudes slightly from the end of the joint, or a special screw/clip device inside the toe.
Tendon Transfer
The A cut is made along the top of the toe and the tendon on the top may be lengthened. Two small cuts are made on the bottom of the toe and the bottom tendon released at the end of the toe. The tendon is split in two and passed through into the cut on the top of the toe and stitched to the tendon on the top. The skin is then stitched up and the toe splinted with paper stitches that hold it in the corrected position.
