- Abnormal lesser toe MTPJ hyperextension with IPJ flexion due to muscular imbalance.
- Patients typically complain of pain at the MTPJ or metatarsalgia.
- Examination may reveal a depressed MTP head with callus formation and tenderness.
- Investigations are not required for diagnosis, management, or referral.
Conservative measures include
- Patient education.
- Shoe wear advice – avoid totally flat, high, or tight shoes. Trainers are appropriate.
- Silicone / foam toe sleeve.
- Diagnostic uncertainty.
- Chronic pain / disability not responding to conservative management.
- Unable to wear normal shoes.