Lesser toe deformity

Mallet, hammer or claw toes

What is it

Non-surgical options

I suggest a deeper and wider, more accommodating shoe. Padding or simple orthotics can decrease rubbing on the prominent parts of the toes.

Surgical options

Lesser toe Joint fusion

To fuse a deformed joint in the lesser toes a cut is made over the top of the joint, which is then removed. The joint is held stable in its corrected position with a wire which sticks out from the end of the toe and is removed in clinic at 6 weeks. 

Sometimes the deformity is caused by the big toe pushing the others over or other more major foot deformities. If this is the case then this deformity would need to be corrected at the same time as the toe fusion.

Risks of surgery specific to this procedure

There is a small chance of the bones not fusing together and this is called "non-union". Smoking and diabetes increase this risk. If this happens you may need further operations to deal with the problem.

What to expect after surgery

  • This will be done as a day case procedure under a general anaesthetic.
  • A local anaesthetic block is used around the ankle to decrease post-operative discomfort.
  • The patient is discharged home from hospital on the day of the operation with painkillers to use as necessary.
  • The patient must keep their foot up above the level of the groin for 23 hours every day for two weeks. This minimises swelling, decreases discomfort and reduces the risk of wound complications and infection.
  • The patient is able to weight bear in a special shoe from day one to move around the house.

Expected recovery milestones

  • At two weeks you will be seen for a wound check; if the wound is healed you will be able to do more walking around but will be quite uncomfortable until six weeks post-operatively when you will be seen again.
  • At the six week appointment an x-ray will be taken to check on the healing of the bone.
  • Between six weeks and three months you should expect to return to work and normal activities. I would expect to discharge you from further follow-up after three months.
  • Between three months and one year there will still be some swelling and minor discomfort.