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Toe Deformities

Cross Over Toe deformity

sometimes one of the lesser toes can cross over the neighbouring toes. This usually involves second toe crossing over the big toe. Associated bunion (Hallux valgus) deformity of the big toe and subluxation or dislocation of the joint at the base of the second toe is a coomon problem.  This can can cause various symptoms including:

  •  pain
  •  Difficulty with shoe wear
  •  Callosities on the dorsum (top) of the second toe
  •  Cosmetic issues
  •  Subluxation or dislocation of the joints
2nd Toe crossing over big toe, associated hallux valgus (Bunion) deformity,  Callosity (thickening of skin) on the top of the 2nd toe Preoperative X ray of the foot, arrow showing the bones crosiing over, hallux valgus deformity
Before surgery Pre-op X ray


The deformity can be corrected surgically with good results. This involves correction of the crossed over toe and bunion surgery at the same time in some cases and may involve:


  •  Open reduction of the subluxed/dislocated joint at the base of the lesser toe
  •  release of soft tissue structures
  •  Repair of ligaments / soft tissues on the appropriate side of the deformity with special bone anchor sutures
  •  Fusion of proximal interphalangeal joint (one of the small joints in the toes)
  •  Hallux valgus (Bunion) surgery


At the time of surgery: Red arrow - Bunin correction with Akin osteotomy, Excision of bony prominence and soft tiisue correction: Green arrow- Fusion of proximal interphalangeal joint of 2nd toe with a K wire: Yellow arrow- Repair of ligaments with a special bone anchor Six weeks after surgery: Both bunion and 2nd toe deformities are corrected with good alignment on weight bearing Six weeks after surgery showing correction of deformities on X ray
X ray during surgery 6 weeks later X ray 6 weeks later


 What to expect after the operation:

  •  Heel walking shoe for four to six weeks
  •  you may have a K wire sticking out the lesser toe for four to six weeks
  •  full weight bearing physiotherapy once the K wire is removed
  • Swelling of the toes is common and usually takes 8 - 12 weeks to settle

GP Referral

Private Health Care

Mr Alavala is recognised as an Orthopaedic Consultant by:

  • BUPA
  • Simply Health
  • Pru Health
  • WPA
  • Aviva