Overlapping big toe

by Diane
(texas)

i have had three surgeries on my left foot. One surgeon for what reason I don't know removed my sesamoid bones while removing a callous from the bottom of my foot. At that time I had toe two and three pinned which left toe number four underlapping. Since the removal of the sesmoid bones my big toe is now extremely overlapping to toe two and three. This causes a lot of pain and shoes are almost impossible to find. Recently, I had another surgery to amputate my little toe because it was swollen, inflamed and dying as a result of one of the surgeries. Is there anything besides surgery that will help me to be more comfortable? Thank you. Diane

RESPONSE

Hi Diane,

As a result of your surgeries your foot sounds like it is more deformed now than it was prior to surgery particularly since your big toe is pointing into left field.

Sesamoid bones are not typically removed for that very reason. When there is a severe callus on the bottom of the foot as a result of an enlarged sesamoid, typically, if it comes to surgery, the affected sesamoid is skived down to reduce its prominence. This way there should be some relief without the big toe moving all the way over.

I also cannot figure out how toe number four ended up under number three. Didn't your surgeon notice this at the time of surgery?

The other mystery to me is why your fifth toe ended up amputated. You do not mention having had any surgery on that toe nor do you mention problems with infections afterwards.

I will assume perhaps that you are diabetic or may at the very least have circulation issues.

So, this raises the question, did you ever go for a second opinion as your situation does not make sense to me?

In any event, if you are looking for a non-surgical solution to your problem you are very limited in your options.

Essentially, you now have an alignment issue with your toes, the big toe is overlapping and second and third toe and the fourth toe apparently is underlapping the third toe, while your second and third toe probably do not bend since you mention they were pinned.

The first thing you will have to do is wear the most conservative, boxy shoes that you can find in order to give your deformed toes, room in the shoe. Depending on how bad your foot structure is, you may even have to consider custom made shoes, where a mold is taken of your foot and the shoe is built around the deformity that you present with.

Option number two is to go on online and look for all the foot "contraptions" that are sold on the internet. There are devices that will help pull your big toe in a more straightened position. The toe will not stay there, but as long as you are wearing the device you may get better alignment, which will also allow the big toe to bend upwards somewhat, when you walk.

They also sell all sorts of devices to put in between your toes made out of various materials. The best material is the one that gives you the most comfort. These devices will straighten your fourth toe so that it does not underlap your third toe.

Probably the best place to look for these devices is www.footsmart.com

Beyond those recommendations there is very little you can do from a non-surgical standpoint. If you decided the overlapping great toe is too painful, you would have to consider having the big toe joint fused, which may or may not be in your best interest, depending on a number of factors, including your age and activity level.

I would suggest you get a second opinion from another doctor in your area and see what your options are.

Marc Mitnick DPM
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