| Other toe deformities Hallux Interphalangeus With this condition there is a Valgus deformity of the big toe. This however exists between the two digits of the toe and not at the "bunion" level (at the first MTP joint).
Unlike a true bunion this tends not to be an acquired problem but rather a developmental varient of the toe.
It may coexist together with a bunion but more commonly exists alone.
The surgical treatment is an Akin osteotomy. This involves removing bone from the inner (medial) side of the big toe, allowing the toe to be "tilted" back into a straighter alignment. It is then fixed with a compressive staple.
In this example the second metatarsal which was relatively long compared to the first and third (and as a result producing pain on its plantar surface) has also been shortened. Bunion with Bunionette & Metatarsalgia In the following case the symptoms are pain from both the inner border of the mildly deformed big toe(hallux valgus), the outer border of the little toe (bunionette) and the sole of the foot (metatarsalgia). All these phenomena are due to excessive pressure excerted upon the overlying skin and soft tissue by the underlying bony prominences.
The surgical treatment is to narrow both sides of the foot by moving the 1st and 5th metatarsals towards the middle of the foot and shorten the other metatarsals (2 to 4) which are prominent in the sole and producing metatarsalgia. Pre & Post Operative Images  |  |  | | Prominences at the first and fifth MTP joints | The sole of the foot with abundant callous under 2-4 metatarsals. | |  |  | | |
Congenital 5th Claw Toe Deformity |  |  | Claw toe intra-operative pictures
| | |  |  |  | | The V shaped incision to allow access for lengthening of tendons and release of contracted joint. | The V shaped incision being closed in a lengthened position, forming a Y shape. | The closed (and lengthened ) Y shaped scar. |  |  | | The corrected 5th toe with strapping in place(required for 6 weeks). | The post operative bandage, required for 2 weeks. |
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