Disorders of the lesser digits are extremely common and are seen by podiatrists daily. Although there could be many causes of pain, one of the most devastating is the dislocation of the second digit joint where the toe meets the foot, often named predislocation syndrome if not fully dislocated.
Often this deformity occurs due to pressure from other foot deformities: bunions in which the first toe under rides the second, a short first or third long bone in the foot which places pressure on the joint of the second, and trauma in which the joint capsule is injured. This injury can result in displacement of the toe or even dislocation and often the tendons and ligaments can elongate or shorten with chronic deformity leading to an extremely rigid second toe that lies over the great toe.
Actions that may be considered by your doctor or podiatrist:
- The location of pain and position and flexibility of the toe will determine treatment options
- Imaging may be ordered including xrays, ultrasound or magnetic resonance imaging (MRI)
- Strapping and taping may improve symptoms if the deformity is mild
- Larger, wider, deeper footwear may take pressure off the second toe
- Orthotics may take pressure off of the joint itself and allow for minimal pain with walking
- If the toe can be reduced to its original position, the doctor may suggest tendon releases or joint capsule sutures if the joint surface has not been damaged
- If the toe is not reducible, the doctor may suggest surgery that includes cutting bone to restore alignment
Predisclocation syndrome is one of the more difficult deformities to treat. You may be limited to accommodating for the dislocated toe with proper footwear or orthotics. Communicate clearly with your podiatrist and they will be able to better serve you and improve your pain.