Is your long toe painful and becoming problematic when wearing closed in shoes? We may be able to help.
A long second toe, also known as Morton’s toe, is relatively common and often does not cause any functional problems. However, in some people, it may cause calluses on the bottom of the foot or the top of toe joints and may also result in hammertoes. People with excessively long second toes also experience difficulty finding footwear to fit comfortably and aesthetic appearance.
Hereditary: is the most common cause of a long second toe. The second toe itself may be long or the big toe may be relatively short compared to the second toe.
Bunion: Deviation of the first metatarsal due to bunion will make the second toe long.
Conservative
Footwear modification: wear supportive footwear.
Regular podiatry visits:
Orthotics: custom-designed orthotics.
Toe protectors:
Surgical
Surgery is advised if non-surgical treatment fails. There are several surgical techniques available to shorten the long second toe. Your surgical podiatrist will discuss with you, which procedure is best for your needs.
Arthrodesis (Proximal Interphalangeal Joint): The most commonly performed surgical technique involves removing part of the bone in the smaller joint of the toes to realign and shorten the toe.
Metatarsal shortening (Weil Osteotomy): Performed if the second metatarsal bone is relatively longer than the adjacent metatarsal.
Arthroplasty: Not commonly performed in younger patients, it involves removing a small portion of the bone in the toe joint.
Cost & Item Codes – Our fees are quoted on a case-by-case basis after your initial consultation with the surgical podiatrist as each patient presents differently and each surgery varies from patient to patient. Please book an initial consultation to discuss this further.
Scans – We recommend you have weight bearing x-rays prior to your appointment.
Telehealth – We may be able to offer an initial telehealth appointment if you live a distance away. Phone one of our friendly staff to see if this is possible for you. We may ask you to email some photos of your toes prior to your appointment.
Do I need surgery? – Although your doctor may recommend an operation to improve toe function of your foot and reduce pain and deformity, it is your decision if you go ahead with the operation or not.
Duration – The operation usually takes between 30-45 minutes. This procedure is day surgery, and you can usually go home the same day.
Anaesthesia – Surgery can be performed under local anaesthesia, or general anaesthesia, depending on the doctor’s and the patient’s preferences.
Medications – Your doctor or anaesthetist may give you antibiotics during the operation to reduce the risk of infection.
Smoking – If you are a smoker, you need to stop the habit of smoking 4 weeks before your operation for normal healing and reduce postoperative complications. Nicotine is known to stop bones from healing.
Patients must follow their doctor’s instructions carefully during recovery to ensure proper healing and minimize the risk of complications.
In general, the following timelines can be expected:
Immediately after surgery: Go home and rest. You will be given a postoperative shoe to wear for 4 weeks. Elevate your foot as often and as much as possible to reduce swelling. Minimal weight bearing with foot/feet elevated, getting up for essential things only like toilet breaks 5-10 minutes maximum per hour.
The first few days: You should avoid walking if possible and only put your weight through your heel in the postop shoe. When not walking, rest with your foot elevated to reduce swelling. Your wound needs to be kept dry until stitches are removed.
1-4 weeks: In the first 2 weeks, keep the foot dry until stitches are removed usually around 10-14 days. Movement is limited out of the house and patients are expected to rest and elevate as much as possible in a post-op shoe even when they are advised they are able to walk. After 4 weeks, your doctor will advise when you can increase movement and stop wearing the post-op shoe.
You should be able to walk comfortably within 2 months, but some swelling may last up to 12 months.
Rest – 1-2 weeks (minimal weight bearing for essential things only like bathroom breaks 5-10 minutes maximum per hour)
Walk – 2-4 weeks (movement limited outside of house)
Driving – 4-6 weeks (for any hospital procedures under general anaesthesia, you cannot drive until after 24 hours when you are off narcotics. Therefore, you will need someone to drive you home from hospital)
Return to sedentary work – 1-2 weeks (If you work at a desk with minimal time on your feet and you are able to elevate your foot/feet)
Return to active work – 6-8 weeks (If you have a physical job or are standing a lot and unable to elevate your foot/feet)
Low impact exercise – 8 weeks (slow walking, cycling, golf using a caddie)
High impact exercise – 12 weeks (fast walking, running, jumping, playing sport)
Some possible complications following surgery include – pain, infection, bleeding, scarring, DVT. Patients should contact their doctor if they have any concerns.
When to consider surgery?
Surgery is considered in patients who have not responded well to non-surgical treatments.
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