Long toe, also called Morton’s Toe, is a very common, hereditary foot condition where the second toe is longer than the big toe, often causing pain and discomfort when wearing shoes. It is particularly painful when wearing shoes where the heel is lifted.
Toe shortening surgery is a minimally invasive surgical procedure whereby the longest toe is shortened so it doesn’t protrude beyond the big toe, relieving the pain, soreness and irritation that can come from Long Toe.
At Jaws Podiatry, we offer the most advanced, state-of-the-art toe shortening surgery aimed at providing aesthetic and functional results for our patients. We don’t use pins or screws and our patients walk immediately after surgery!
The name, long toe, is actually a misnomer because technically the condition has nothing at all to do with the toes themselves.
It concerns the metatarsals, which are the five bones connecting the phalanges, which are found in the middle of the foot.
They connect to the tarsals (the bones in the back of the foot).
If this abnormality exists, the metatarsal connected to the big toe is shorter than the second metatarsal, and that’s the reason there is a longer second toe.
Toe shortening surgery can correct this condition!
Genetics is the most common cause for this foot abnormality.
The random throw of DNA dice renders all of our physical characteristics, and unfortunately, a long toe is among them.
This condition usually but not always occurs on the second toe. Other monikers include: Morton’s toe, Greek toe, turkey toe, royal toe, and Viking toe.
The ancient Greeks venerated a long second toe as the ideal of physical perfection.
This was evidenced by the many marble statutes created during their days of splendor.
The Vikings believed that a long second toe meant a long life. In the practice of psychic foot reading, a long toe is said to signify leadership or royal ancestry.
Long toes are common and easily recognizable. If the second toe projects out farther that the big toe, that is it.
A 1999 study that was published in The Foot (Volume 7, Issue 1) indicated that 42.2% of American college students had longer second toes. The numbers were higher with males than females, with men numbering 45.7 percent and women 40.3 percent.
According to Dr. Abraham Wagner, a long toe can hit the end of a shoe first, extending past the others and causing the toe to curl and jam.
If left untreated, over time this rubbing action can cause a hammertoe or corn to form on top of the toe.
In addition, the constant jamming can also cause the dislocation of the toe over the metatarsal bone, which in turn results in a painful callous on the ball of the foot.
This also occurs when the metatarsal bone behind the toe is too long, and to correct this surgically would require an additional procedure to the toe shortening.
Long toes are not only cosmetically problematic; they also affect foot function. Many are known to cause considerable pain, particularly on the tip of the toe, while others may not.
Sometimes, people mistake a long toe for the unwanted skin accumulation of a corn.
Irritation, swelling, warmth and redness are all symptomatic of this abnormality.
Pain can have a wide range from tender to the touch and mild to relentless and piercing.
Whatever degree, it is always worsened by ill-fitting shoes that crowd the toes.
Pain on the tip of a toe that is longer than all the others and causes the formation of thick callouses and open wounds is a clear indication of the need for toe shortening surgery.
In addition to the pain, there is also discomfort in wearing shoes and walking.
Surgery will alleviate the pain and prevent further deformity to the toe.
Performed as an outpatient surgery under a local, regional, spinal or general anesthetic, this means that the patient will go home on the same day.
The most commonly used are local and regional blocks with monitored anesthesia.
The area is completely numbed during the surgical process, but some pain may ensue afterwards.
Some degree of soreness and tenderness is normal, minimal and can be easily managed by prescription medications.
While there are medical indications that warrant the shortening of a toe, a reduction in pain and an increase in self confidence are two biggest benefits of this procedure.
Both aspects lead to increased activity and an improved quality of life.
Many patients are embarrassed about the way their feet look in open-toed shoes or barefoot in the sand at the beach.
This surgery can help to elevate self esteem and mark a return to normalcy and wearing preferred footwear. (Stay away from too much time in those high heels though, ladies!)
Any type of surgery involving any anesthesia has some inherent risk, although the benefits of toe-shortening surgery far outweigh them.
Complications may occur that are not necessarily the fault or either the patient or the surgeon.
The highly experienced and talented staff at Jaw Podiatry take the utmost care, and it isn’t likely that issues will occur.
Nevertheless, they can include: infection, pain, poor wound healing, nerve injury or the need for repeat surgery, to name a few.
This minimally invasive outpatient procedure takes up to three hours due to the effects of anesthesia or sedation.
The surgeon is likely to use one of two methods to remove a piece of the bone in the toe in order to shorten it.
These are joint resection (arthroplasty), which concerns the removal of a piece of one of the small toe joints, or bone mending (fusion) that shortens the toe by removing an entire small joint, which allows the two bone ends to heal into a shorter position.
The surgeon may also utilize a wire or implant to maintain bone stability throughout the healing process, after which it will be removed.
This is very common protocol, and the type of hardware utilized will depend upon the severity of the problem and which toe is operated on.
In the case of the fifth toe, this rarely happens but with the second toe, it is almost always necessary.
Surgical hardware varies and it can be in the form of stainless steel wires, synthetic material, screws, absorbable pins, cadaveric bone, and/or customized fixation devices.
Complete recovery from toe shortening surgery is dependent on the type of surgery performed.
Usually six weeks is a fair estimate for patients who are in good health to heal.
There are no shortcuts to recovery; it takes as long as it takes, or more colloquially put, “it is what it is.”
Returning to normal activities, however, is a horse of another color, so to speak, and usually requires between two weeks to two months, depending on how severe the deformity was.
Scarring is usually minimal and often disappears within the folds of the toe.
Simple toe surgery recovery time can be as short as two weeks.
While it may be possible to wear regular shoes and return to normal activities within that time frame, it can take up to 3 months for more severe cases.
Other factors that affect recovery include: smoking; age and malnutrition.
Walking after toe-shortening surgery will depend greatly upon which toe received the surgery.
If it was performed on the 4th or 5th toe, mobility and a return to normal shoe wear is usually assured rather quick because these toes are not integral to the propulsion process involved in walking.
In the case of the second toe, recovery is certain to take more time because it is vital to maintaining momentum while walking.
In Conclusion
Our specialists are always here to help!
Our collective caring and highly professional staff offer treatment plans that are customized to suit the individual needs of all of our patients.
We understand and are constantly challenged by the fact that all feet are unique as is every patient that passes through their doors in need of professional attention.
We are dedicated to eliminating foot pain and restoring the quality of life that everyone deserves!
No matter where you are throughout Florida, the country or the world, we are changing lives locally, nationally and globally one cometic foot surgery at a time.
Please feel free to schedule an in-person or virtual consultation today and let our minimally invasive, surgical procedures reshape your feet and your life!
