Bilateral flatfoot before Surgery and  Bilateral flatfoot after Surgery
Ankle Arthroscopy and Subtalar Arthroscopy
Ankle Arthritis in Rhuematoid patient and Ankle Replacement in Rhuematoid Arthritis
Diabetic foot before Surgery and Diabetic foot after Surgery
Claw toe deformity in Rhuematoid patient and Claw toe deformity in Rhuematoid patient after surgery
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Lesser Toe Problems

Claw Toe/Hammer Toe/Mallet Toe

  lesser toe problems      

Hammer, Claw or Mallet toe is bending of one or both joints of the second, third, fourth, or fifth (little) toes. The exact point of bending and pain is shown in the picture. This abnormal bending can put pressure on the toe or sole of the foot when wearing shoes, causing callosities to develop. Lesser toe deformities are associated with Hallux Valgus or Bunion and are commonly seen in Rheumatoid Arthritis. They cause pain in the foot.

Hammertoes usually start out as mild deformities and get progressively worse over time. In the earlier stages, hammer and claw toes are flexible and the symptoms can often be managed without surgery.

But if left untreated, hammer and claw toes can become more rigid and toe surgery is needed to correct the deformity. Surgery on the foot can be done under local anaesthetic block and you can return home same day. A wire is usually used to keep the toe corrected after surgery. It takes 6 weeks to recover from this surgery.

  claw toe surgery      

Case 1

Here is a 63 year old lady with severe Hallux Valgus and crossover deformity of her toe. There is clawing of second, third and forth toe associated with Hallux Valgus. Deformities of third and forth toe are flexible.

hallux valgus with claw toe on right and hallux valgus with cross over toe on left side
  hallux valgus with cross over second toe  
xray  picture before and after corrective surgery

She choose to have corrective surgery to her first and second toe. X-ray picture above shows healing after 6 weeks of surgery.


Metatarsalgia is pain that occurs in the ball (or metatarsal region) of the foot. It is associated with thickening of the plantar skin underneath the ball of your foot because of pressure from metatarsal heads.


One can feel burning or aching sensation in the forefoot or can have have shooting pains, tingling or numbness in the toes. Some people also experience a ‘walking on pebbles’ sensation. 

Metatarsalgia is a common foot problem with a number of different causes, such as badly fitting footwear, being overweight and certain medical conditions (for example, Rheumatoid arthritis, cavus foot, diabetes, ). Older people are more susceptible. Anything that adds extra strain or pressure on the ball of the foot can bring it on.

The treatment of mechanical metatarsalgia initially consists of orthotics and modified shoe wear including metarsal bar and insoles to try and offload the painful area. These are fitted by our Podiatry services.

Should this fail there are a number of surgical options including shortening osteotomies of the metatarsals such as a Weil osteotomy, or in the case of severe rheumatoid arthritis excision of the metatarsal heads.

Surgery can be done under local anaesthetic block and or general anaesthetic. You can return home same day. A wire is usually used to keep the toe corrected after surgery. It takes 6 weeks to recover from this surgery. 

metatarsalgia before and after surgery