Lesser Toe Deformities and Corns

The lesser toes are all the toes other than the big or great toe.
Corns are often painful thickened areas of skin on the toes. A hard corn forms where the skin is dry typically over one of the knuckles (joints) of the toes that will tend to rub on footwear.

A soft corn occurs where the skin is moist such as inbetween toes. The corns develop because of abnormal pressures on the skin, and is often because of poorly fitting shoes. Underneath every corn there is a prominence of bone and pressure from the shoe causes the skin to thicken.

A corn may eventually break down and thus not protect the toe. An ulcer can develop which can get infected.
There are three main deformities of the lesser toes. A hammer toe, a claw toe, and a mallet toe.

There are three main deformities of the lesser toes. A hammer toe, a claw toe, and a mallet toe.

There can be many different causes that include muscular weakness, congenital diseases, arthritis but most are due to poorly fitting tight shoes.

High heeled shoes with a narrow pointed toe box cause the toes to bunch up and the joints contract causing increased pressure on the toes. Over time the contracted joints will become stiff which makes treatment more difficult.

The simplest treatment is to modify your shoes to accommodate the toes. This can either be in the form of a larger shoe or open sandal type shoe. Alternatively, there are various pads and cushioning devices that can be used to relieve the pressure on the joint in question. A lot of these can be purchased in most high street chemists.

Surgery should only be undertaken if the above non-operative measures have failed. The aim of the surgery is to remove the deformity and straighten the toe so that it will lie in a more normal position in a shoe. It is usually done under a general anaesthetic but it can be done under local anaesthesia.

The exact procedure will depend on the type of deformity but often a wire will be placed across the joints in the toe to either hold the toe straight after a tendon has been released or to hold the joint still so that the joint will fuse together. The wire will be bent over the tip of the toe and will have a dressing to cover it up. The wire is usually removed four to six weeks after the surgery in the clinic.