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Oxford University Hospitals NHS Foundation Trust
Foot and Ankle

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Lesser toe deformities

The lesser toes are those other than your big toes; 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.

The big toe has only one interphalangeal joint, but the lesser toes have two. The most common types of deformities which affect the lesser toes are covered below.

Claw toe. A claw toe is caused by one of the tendons in the foot contracting. The first bone is raised and the second two bones point downwards.

Hammer toe. The three bones in the toe should form a straight line, but with a hammer toe the first bone is slightly raised, the second bone tilts downwards and the bone at the tip is almost flat - this condition is also caused by one of the tendons in the foot contracting.

Mallet toe. Again, this condition is caused by one of the tendons in the foot contracting. The first two bones are straight but slightly raised and the bone at the tip is point downwards.

Diagnosis and treatment. Your consultant will examine your foot using a range of indicators to assess your condition including flexibility, stability and sensation and will check for swelling, calluses and redness. Your foot will probably also be X-rayed - this will show the surgeon the extent of the deformity.

Most lesser toe deformities will require surgery. Claw, mallet and hammer toes can be treated using minor procedures which include the release of trapped soft tissue and tendon lengthening. However, fusion may be required for more acute deformities. This will involve the surgeon removing the cartilage from the end of the toe bones in the middle joint. A removable pin is then used to hold the two cut ends together so that the bones can fuse together.