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Toe Shortening

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What is toe shortening? 

A long toe is an abnormally long toe that can be straight or buckled. Over time, a straight long toe can buckle itself and form a hammer toe. All toes on the feet can be affected by this issue, but the most commonly affected to is the 2nd one.

Causes: Long toes are primarily hereditary, and can be inherited from genetics.  The toe itself may be excessively “long” or the toes adjacent may be short in comparison – making a toe appear long.  A short big toe will make the 2nd toe longer.  Bunions can effectively shorten the great toe, making the 2nd toe appear longer. The presence of a bunion with a long 2nd toe can snowball into to a hammer or crossover toe. 

Sign & Symptoms: Pain is commonly associated with the tip of the long toe.  Excessive pressure from shoes may result in the formation of calluses on the tip of the toe. A buckled long toe can also cause pain and callus formation over the toe knuckles.

The toe(s) may become irritated, red, warm, and/or swollen, with pain ranging from dull and mild to severe and sharp. Pain is often made worse by shoes, especially designs that crowd the toes. Sometimes, long toes are not painful at all. Painful toes can prevent you from wearing stylish shoes.

There is risk for a long toe to develop into a hammer toe if the tip of the shoe pushes directly on the toe – causing it to contract. If the issue isn’t handled, the toe may become permanently contracted. 

Diagnosis and Treatment: Non-surgical methods for a long toe are designed to decrease symptoms and/or limit the issue from snowballing into a larger problem

Simple treatments patients can do are:
•    Wear supportive shoes
•    Use arch supports
•    Wear shoes with a wide toe box
•    Modify your activities/exercise
•    Periodic callus care

Long toes can be surgically shortened. Depending on the severity and length of the toe, there are several methods to surgically correct shorten a toe. In general, the surgery involves removing a portion of the bone at the contracted joint to realign the toe.

Recovery: Recovery from toe shortening surgery is like recovering from a hammer toe surgery, depending on the method of surgery performed. In all cases, healing takes about six weeks in healthy people with no way to catalyze it. Patients often return to normal activities and shoe gear by 2-12 weeks depending on how severe the toe deformity was before surgery. Simple toe surgery can recover within two weeks. Factors that may prolong healing are age, smoking, poor nutritional status, and some medical problems.

Dr. Ray Lopez

Minimally Invasive Bunion Surgery