Toe surgery

Your consultant may recommend corrective toe surgery if you have pain or deformity in your toes or feet that hasn’t improved with other treatments such as medication, physiotherapy or steroid injections. Toe surgery can be used to correct toe deformities, improve comfort and mobility, relieve pain, and treat conditions like arthritis and metatarsalgia.

A toe deformity is when one or more of your small (lesser) toes is an abnormal shape. The lesser toe is made up of three bones (phalanges) ligaments, tendons and muscles. The movement of your lesser toes is controlled by larger muscles and tendons in your legs. Toe deformities can occur when there is an imbalance between the muscles and tendons within your foot and those in your leg. 

Causes of toe deformities

Toe deformities can have several causes, including:

Genetic factors

Congenital toe deformities such as polydactyly (extra toes), syndactyly (webbed toes), and brachydactyly (short toes) are present at birth

Poorly fitting footwear

Wearing shoes that are too narrow around your forefoot can crowd your toes together and cause or worsen toe deformities

Injury

A direct injury to your toe or foot can result in toe deformity.

Inflammatory joint disease

Arthritis can alter the shape and position of your toes.

Neuromuscular conditions

Conditions that lead to muscle weakness such as cerebral palsy can cause toe deformities.

Metatarsalgia

A condition where the ball of your foot becomes inflamed and painful due to overuse (activities like running, jumping or standing for long periods), or wearing footwear such as high heels.

Types of toe deformities

There are several types of toe deformity including:

Claw toe

An upward bend in the second joint and a downward bend in the last joint, resulting in a claw-like appearance.

Mallet toe

A downward bend in the last joint at the end of the toe.

Hammer toe

A downward bend in the first joint of the toe that causes the end of the toe to touch the ground, often leading to corns or callouses on the tip of the toe.

Bunions(Hallux Valgus)

Occur when some of the bones at the front of the foot move out of place causing a bump to develop at the base of the big toe.

Overlapping (crossover) toes

Commonly seen in people with bunions, when one toe crosses over the next toe.

Retracted toes

The toes are bent and don’t touch the ground when you stand.

Curly toes

When the third, fourth and fifth toes curl under the foot because the tendons are too tight.

Webbed toes (syndactyly)

A condition where the toes are joined together by extra skin between the toes. 

The cost of toe surgery will depend on various factors, including the hospital and consultant you choose, as well as your reasons for having surgery. Toe surgery encompasses many different procedures, so it’s hard to give one price.

Below we’ve given some example prices for surgery on one foot or two feet. If you know what type of toe surgery you need, give us a call and we can give you a personalised quote.

The below prices are just a guide price for people paying for their own treatment. They include the cost of the surgery and your aftercare, but not your initial consultation fee. You will also have to pay separately for any tests or scans used to reach a diagnosis.

If you have private medical insurance, private toe surgery will often be covered by your policy. Speak to your insurer to find out.

Forefoot surgery cost - one foot

Please be aware that the following prices are a guide price. Your final price will be confirmed in writing following your consultation and any necessary diagnostic tests.

Any diagnostic tests that are carried out will incur a fee and if you see a consultant to go through your results they may also charge an extra consultation fee.

Patient pathway	Initial consultation	Diagnostic Investigations	Main treatment	Post discharge care	Guide price
Hospital fees	N/A	Not included	£7,329	Included	£7,329
Consultants fees from	£200	N/A	Included	Included	£200
Guide price	£7,529

Forefoot surgery cost - both feet

Please be aware that the following prices are a guide price. Your final price will be confirmed in writing following your consultation and any necessary diagnostic tests.

Any diagnostic tests that are carried out will incur a fee and if you see a consultant to go through your results they may also charge an extra consultation fee.

Patient pathway	Initial consultation	Diagnostic Investigations	Main treatment	Post discharge care	Guide price
Hospital fees	N/A	Not included	£8,673	Included	£8,673
Consultants fees from	£200	N/A	Included	Included
Guide price	£8,873

 

The main benefits of toe surgery are reduced pain, improved mobility, increased comfort and a better cosmetic appearance. Your toes will be straighter, and you will be able to wear normal shoes after your toe surgery.

Toe surgery is normally only considered when other treatments haven’t worked to relieve symptoms.

Non-surgical alternatives to toe surgery include padding, strapping or taping your toes to relieve pressure and pain; using modified footwear or orthotics; physiotherapy; and medication to relieve pain and inflammation.

At your first consultation, you will be seen by a consultant orthopaedic surgeon, a doctor specialising in conditions affecting the bones, joints, tendons and ligaments.

Your first appointment is important as it’s where you’ll meet your consultant, the doctor responsible for your care. During this appointment, your consultant will ask you about your symptoms, medical history and general health. They will perform a physical examination of your feet and toes, which includes looking for signs of deformity, discolouration or swelling, gently pressing (palpating) your skin to assess pain, tenderness and instability, checking how well you can move your feet and toes, and assessing your gait (how you walk).

Your consultant may ask to see the results of any tests or scans you have had previously, or they may arrange them on the day.

These may include:

• Blood tests: To assess your general health and check for any underlying medical conditions.
• Imaging tests: Such as an X-ray, MRI or ultrasound to check your bones and soft tissues.

During your appointment, your consultant will spend time getting to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. At Circle Health Group, we want you to be as well-informed and comfortable as possible during your time with us, so please discuss any questions or concerns with your consultant during your appointment.

After your initial appointment, your consultant will provide a diagnosis based on your symptoms, physical examination and the results of your tests and scans. We’ll do this as soon as possible, so you won’t be waiting long.

Your consultant will decide if toe surgery is a suitable treatment for you and recommend the best procedure for your diagnosis. They will explain the procedure fully including how to prepare, what happens during the surgery, any possible risks and complications and what to expect during your recovery.

There are several types of surgery to correct toe problems. Your consultant will recommend the most suitable procedure for you depending on your symptoms, diagnosis, general health, and expectations for treatment.

Bunion Surgery (bunionectomy)

Bunion surgery involves realigning the bones to correct the deformity and relieve pain and inflammation. Bunion surgery can be performed in several ways:

• Exostectomy: The bunion is removed
• Osteotomy: The bones are cut and realigned into the correct position
• Arthrodesis (joint fusion): An operation to straighten your toes by fusing the bones together
• Resection arthroplasty: Damaged parts of the joint are removed
• Lapidus procedure: The joint between the big toe and the midfoot bone is fused

Lesser toe surgery

Lesser toe surgery aims to correct the deformity, straighten and realign the small toes, improve mobility and function and alleviate pain. Lesser toe surgery includes hammertoe surgery, mallet toe surgery and claw toe surgery.

There are several types of lesser toe surgery:

• Arthrodesis (joint fusion): The bones are fused together to straighten the toe
• Arthroplasty:  The damaged joint between the toe bone is removed
• Tenotomy: The tendons are cut to lengthen them and straighten the toe
• Tendon transfer: A tendon is transferred from the underside of the toe to the top of the toe to straighten and realign the toe
• Osteotomy: The bones are cut and realigned to straighten the toe

Toe shortening or lengthening surgery

Surgery to make your toes longer or shorter can be used to treat conditions like Morton's toe (long second toe) or brachymetatarsia (short toes). 

Toe lengthening surgery can be performed in two ways:

• External fixator lengthening: The toe bones are broken, and an external fixator is applied to gradually increase the length of the toe over one to two months
• Bone graft lengthening: Uses a small piece of bone taken from another part of your body such as your heel bone to lengthen your toe

Toe shortening surgery involves removing part of the bone or joint in your toe.

Big toe joint replacement

Also known as a metatarsophalangeal joint replacement or big toe arthroplasty, this is a procedure where your damaged big toe joint is removed and replaced with an artificial one called a prosthesis.

It may be performed to treat conditions such as osteoarthritis or rheumatoid arthritis.

Toe amputation

Toe amputation involves surgery to remove one or more of your toes. You may need to have your toe amputated for several reasons including trauma, infection, or toe deformities. 

Your consultant will tell you everything you need to do to prepare for your toe surgery. Instructions on how to prepare will also be in your appointment letter. 

If there’s anything you’re not sure about, or if you have any questions, please contact the hospital for advice. 

Pre-operative assessment

Around a week or two before your surgery, you may need to attend the hospital for a pre-operative assessment to make sure you are fit for surgery. Take any medication you take regularly with you to your appointment. At the preoperative assessment, we will check your weight and blood pressure and order tests such as a blood test, chest X-ray and electrocardiogram (ECG) to evaluate your general health.

Optimise your general health

It's important to be in the best possible health before your toe surgery as this will allow your procedure to go as smoothly as possible, speed up your recovery and reduce the risk of any complications after your surgery.

To ensure you are as healthy as possible before your surgery:

• Stop smoking at least eight weeks before your procedure. Smoking increases the risk of complications such as breathing difficulties and infection and can impair wound healing. Your consultant can offer you advice and support with quitting smoking before your surgery
• Follow a healthy, nutritious diet
• Take regular exercise
• Avoid alcohol for a few days before your surgery. Alcohol thins your blood and can increase the risk of bleeding during your operation

Preparing your home

You can aid your recovery by making some preparations in advance. These include: 

• Stock up on food and prepare a few meals in advance that you can freeze and heat up during your recovery
• Arrange for child and pet care if needed
• Arrange for someone to help you with household chores such as shopping, cooking, laundry and cleaning during your recovery
• Move items you could trip over like low tables, magazine stands and rugs out of the way before your toe surgery
• Keep things you use regularly such as your glasses, medications, useful telephone numbers, a book and the TV remote control within easy reach

Regular medications

Your consultant may tell you to stop taking certain medications, such as blood thinners for a few days before your surgery. This is to minimise the risk of bleeding during and after your procedure. 

On the day of your surgery

On the day of your surgery, take a shower before you arrive at the hospital. Do not apply any products to your skin such as lotions, creams, makeup or perfume. Leave any valuables and jewellery at home.

Your healthcare team will give you instructions on when you can last eat and drink before your toe surgery. 

Before your surgery, you’ll need to sign a consent form to say that you agree to have the procedure and are aware of what it entails and the possible risks and complications of the surgery.

What happens during your toe surgery depends on your diagnosis and the type of toe surgery. Toe surgery may be performed under general anaesthetic, which means you’ll be asleep for the procedure, or local anaesthetic, where you will be awake, but the area being operated on will be numb and you won’t feel any pain. Your consultant will discuss the type of anaesthesia you will receive before your surgery.

Toe correction surgery may involve releasing, lengthening, or transferring tendons, putting joints back into place, straightening your toe, or removing or changing the shape of a bone. Your consultant may fix your toe in place with wires or tiny screws to keep it in the correct position while it heals.

Recovering from any type of surgery is a gradual process that is different for everyone.

Recovering from toe surgery depends on several factors including your age, general health, the type of procedure you had and your individual recovery process. You can help your recovery to go more smoothly by being as well informed as possible about your surgery and recovery, taking things at your own pace and following your consultant’s post-operative instructions carefully. Call the hospital if you have any questions or concerns.

How many nights will I need to stay in hospital?

You may be able to go home on the same day as your surgery, or you may need to spend one night in hospital.

Will I be able to drive home?

You will not be able to drive yourself home from the hospital after your toe surgery. Please make arrangements for someone to collect you or we can organise a taxi if you prefer.

How soon can I go back to work?

When you can return to work after your toe surgery depends on the type of procedure you had, your individual recovery and the job you do. If your job is sedentary, such as an office job, you may be able to return to work after a week or two. You’ll need to sit with your foot elevated most of the time for at least the first week after surgery to reduce swelling. If you have a physically demanding job that requires a lot of standing, walking or heavy lifting, you may need to take six to eight weeks or longer off work after your toe surgery.

When can I drive?

You can drive when you can safely control your vehicle and perform an emergency stop. This is normally at least four to six weeks after surgery.

When will I be back to normal?

You will likely have some pain and swelling after your toe surgery and will need to rest with your foot elevated for at least the first week after your procedure. Your consultant will prescribe medication to help manage any pain. You will need to wear a special shoe or boot for several weeks after your toe surgery, and you may have to use crutches or a walker to avoid putting any weight on your toe while it heals.

It can take six weeks or longer after toe surgery for the swelling to go down enough for you to wear a normal soft shoe. During your recovery, build up your activity level gradually and stop if you feel tired or have pain. Wait until you get the all-clear from your consultant before resuming exercise or strenuous activity after your toe surgery.

Most people are fully recovered and can resume their previous normal activities by around three to four months after toe surgery. 

Toe surgery is a generally safe procedure, but as with any type of surgery, there is a small risk that complications can occur. 

Your consultant will explain all the possible risks and complications of your surgery before your procedure and answer any questions you may have. It’s important that you are fully informed about any possible risks and complications before your procedure and are able to make an informed decision.

Possible complications of any type of surgery include:

• Adverse reactions to the anaesthetic
• Bleeding
• Blood clots in the legs or lungs (deep vein thrombosis/ pulmonary embolism)
• Wound infection
• Damage to nearby structures
• Chest infection

Possible complications specific to toe surgery include:

• Damage to the nearby nerves or blood vessels
• Problems with bone healing
• Loss of movement in the toes
• Severe pain, stiffness and loss of use of the foot (Complex Regional Pain Syndrome)
• Pain in the ball of the foot
• The deformity may reoccur
• Floating toe syndrome (a condition where your toes do not make contact with the ground while standing)

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about private toe surgery book your appointment online today or call a member of our team directly.

1. Hammer toe surgery (Arthroplasty/Arthrodesis) North Tees and Hartlepool NHS Foundation Trust
2. Lesser toe surgery The Royal Orthopaedic Hospital NHS Foundation Trust
3. Management of Toe Deformities Chelsea and Westminster NHS Foundation Trust