Cross-over Toe Surgery

Based in the heart of NY, Advance Foot and Ankle Solutions offers the best facility for performing cross-over toe surgery, while catering to all other various foot and ankle problems. Look no further when you can have direct access to the globally acclaimed specialist team of foot and ankle surgeons, supervising & managing your cross-over toe surgery with diligence and dedication.

Advance Foot and Ankle Solutions support team is absolutely attentive to your requirements related to cross-over toe surgery. Call & book an appointment right away for professionally diagnosed, treated and empathetically cured foot and ankle issues, to lead a wholesome, enviable lifestyle.

Cross-over Toe Surgery: The Condition Outlined

Crossover toe is a multi-anatomical deformity that involves the major structures of the forefoot. It is characterized by a 2nd toe that drifts towards the big toe and eventually may lead to it crossing over and resting on top of the big toe. It is a progressive condition that can develop at any age, but it is most common in adults.

Some people confuse crossover toe with a hammertoe, probably because both conditions involve a toe that does not lie in the normal position. However, crossover toe is entirely different from a hammertoe, and much more complex.

Treatment can range from a simple hammertoe correction to a complex correction of hallux valgus. Other surgical options may include correction of metatarsalgia or correction of extensor apparatus contracture and rupture of the plantar plate leading to dislocation.

Cross-over Toe Surgery: The Underlying Causes Of The Condition

Several causative factors can be attributed to the crossover toe deformity, listed below:

  • Idiopathic (Cause Unknown)
  • Hypermobility Of The 1st Metatarsal
  • Long 2nd Metatarsal
  • Structurally Unstable Arch
  • Acute Trauma (Plantar Plate Rupture)
  • Flat Feet
  • Bunion (Hallux Valgus)
  • Big Toe Joint Arthritis (Hallux Rigidus)
  • Tight Calf Muscle

Cross-over Toe Surgery: The Associated Symptoms & Indications

The symptoms of crossover toe may include:

  • Persistent Pain In The Ball Of The Foot beneath the 2nd toe
  • Swelling In The Joint as the condition progresses
  • Increased Warmth in the joint
  • Callosity (Skin Thickening) beneath the 2nd MTP joint
  • Worsening Pain while walking
  • Ulceration Of The 2nd Toe on its dorsum or plantar aspect
  • Deep Infection in ulcers

Cross-over Toe Surgery: The Treatment Options For The Condition

Your professional orthopedic specialist would appreciate as you go fixing a meeting with him so that your foot condition might be evaluated and diagnosed to proceed further. Crossover toe is a progressive condition that gets worse over time and treatment outcomes are significantly improved if medical aid is sought at its very onset.

The Nonsurgical Treatment: The Nonsurgical means of treatment may include the following:

  • Resting & Applying Ice Packs to reduce pain & swelling
  • Altering Footwear by replacing tight & high heeled shoes with broader ones with stiff, supportive soles
  • Placing Shoe Inserts as orthotics to relieve pain & swelling by reducing pressure on the affected zone
  • Wearing Toe Sleeves made of silicon to protect from direct pressure and rubbing force against the footwear
  • Applying Physiotherapy via stretches & strengthening exercises that help reverse the muscle imbalance
  • Immobilizing The Foot for a temporary period to let the injured tissue healed
  • Taping Or Strapping Firmly the affected toe to provide it stability & neutral position while reducing pain & inflammation
  • Taking Medication in the form of NSAID’s to manage the conditions of pain & discomfort

The Surgical Approach: Once the 2nd toe begins moving toward the big toe, it will never return to its normal position unless surgery is performed. A variety of surgical options exist and your foot and ankle surgeon will select the procedure or combination of procedures best suited to the individual patient and extent of deformity. Surgical management is reserved for patients who have failed to respond to non-operative treatment. In general, mild deformities can be treated via soft tissue procedures while severe deformities may require the addition of a bony corrective surgery.

  • The Soft Tissue Procedures
    • Dorsal And Medial 2nd MTP Joint Capsular Release: With the passage of time the joint capsule tightens up; releasing this allows the toe to return to a more normal position
    • Extensor Tendon Lengthening: Releasing these tight tendons allows the toe to return to a more normal position
    • Flexor To Extensor Tendon Transfer (Girdlestone-Taylor Procedure): This procedure involves releasing one of the tendons that pulls the toe downwards at the end of the toe. The tendon is then transferred to the top of the toe. This procedure aims at converting one of the primary deforming forces that results in clawing of the toes into a corrective force. It is a technically more demanding operation and recovery is slightly longer as a result
  • The Bone Procedures
    • Shortening Osteotomy Of The 2nd Metatarsal: By shortening the metatarsal bone the aim is to correct the imbalance in the soft tissues indirectly
    • PIP Joint Fusion/Arthroplasty: The fixed bend at the PIP joint is corrected by removing some of the joint and fusing the toe in a corrected, straightened position. It is usual for this joint not to fully heal with the bone, but even a fibrous union (scar tissue) in a straight position will be effective in majority of patients. The bones are held in place by a temporary metal wire (K-wire) which is removed at roughly 4-6 weeks
  • The Combined Soft Tissue & Bone Procedures
    • Minimally Invasive Technique: Soft tissue releases percutaneously (2nd MTP joint capsule, EDL and PIP plantar plate); basal plantar closing wedge osteotomy to proximal phalanx
    • Plantar Plate Repair
  • Chronic Dislocation
    • May require transfixing the toe to the metatarsal with a K-wire (temporary metal wire)
    • In the presence of severe infection or uncorrectable deformity resulting in significant symptoms, rarely an amputation may be considered

Cross-over Toe Surgery: The Postsurgical Care & Recovery

Surgical treatment for crossover toe involves several weeks or months of recovery depending on the type of surgery performed and the age of the individual. The useful tips for care and complete recovery requires the following measures to be adopted as suggested by the podiatrist:

  • Applying Bandage To The Operated Foot
  • Wearing Stiff-soled Shoes
  • Keeping The Repaired Foot Elevated While Lying
  • Avoiding Moist & Warm Conditions To Prevent Infection
  • Performing Intrinsic Foot Muscle Strengthening Workout

Cross-over Toe Surgery: The Possible Complications

Potential complications of non-operative treatment mode include:

  • Worsening Pain
  • Increasing Deformity
  • MTP Joint Dislocation
  • Dislocation Of 2nd Toe
  • Formation Of Ulcers On The Plantar Aspect Of 2nd MTP Joint
  • Formation Of Ulcers Across The Dorsum Of The 2nd Toe As It Rubs Against The Shoe
  • Infection Of Ulcers

Potential complications of the surgical treatment mode include:

  • Risks And Complications Of Anesthesia
  • Excessive Bleeding
  • Bacterial Infection (Superficial And Deep)
  • Formation Of Blood Clots
  • Failure To Fully Correct Deformity
  • Floating Toe
  • Recurrence Of The Deformity
  • Stiffness Of The 2nd MTP Joint
  • Lesser MTP Joint Arthritis
  • 2nd MTP Joint Arthritis
  • Wound Healing Problems
  • Compromise To The Blood Supply
  • Need For Revision Surgery
  • Complex Regional Pain Syndrome