It’s common for people to have what’s known as Morton’s toe. It’s a simple condition where the second toe is longer than the big toe. The feet can be completely healthy, just with an odd feature. However, many people have issues with the unique structure. A Morton’s toe can cause calluses on the sole of the foot, crunch the long toe to fit into shoes, and other painful issues. While adding pads into shoes can help, there is another solution: toe shortening surgery.
What is Morton’s toe?
Morton’s toe is easy to diagnose. If the second toe is the longest toe on the foot, it’s typically Morton’s toe. It’s also common. In one study, 107 college students, 70 female participants and 37 males, participated in an online survey. In the end, 42% of the students reported having second toes longer than their big toes, with a fairly even female to male ratio. 
This condition is hereditary, and it occurs when the long bone (metatarsal) in the big toe is shorter than the metatarsal in the second toe. Therefore, the second toe looks longer than the big toe. The disadvantage of this comes when more weight is placed on the thinner metatarsal in the second toe as opposed to the thicker metatarsal in the big toe. Therefore, people may experience pain in their feet, particularly near the arch and the second toe.
“Long toes are not simply a cosmetic issue, they can in many cases result in a buckling of the toe itself which over time becomes permanent,” said Stuart Metcalfe, consultant podiatric surgeon at Footconsultant. “This is in turn often leads to increased pressure over the tip of the toe and over the top of the knuckle joint of the toe. The problem is that these changes develop slowly over time and often the underlying cause goes unnoticed by patients.” 
If pain occurs, a doctor might recommended placing a flexible pad under the first toe to better distribute the weight on the foot. Other treatment can include exercises to stretch and strengthen the foot muscles, over the counter pain-relievers or prescription-strength anti-inflammatories, or custom orthotics to place into shoes.
Why Try Toe Shortening Surgery?
But if the issues continue, a doctor may recommend toe shortening surgery. There are two types of procedures for this. The first is joint resection, where surgeons remove a small piece of one of the toe joints. The second is called arthrodesis, where they remove an entire joint in the toe and the bone ends rejoin as they heal. In the meantime, the bones are held in place with an implant or wire and stitches. It takes several weeks to recover before walking on that foot again.
However, this surgery is usually prescribed for patients with pain issues not helped by conservative treatments. In general, foot surgery for only cosmetic reasons is not recommended. “Cosmetic surgery on a pain-free, well-functioning foot is never appropriate,” said Jonathan T. Deland, MD, who is an orthopaedic surgeon and Chief of the Foot and Ankle Service. “…When you’re dealing with the foot, we’re talking about a structure you walk on, that serves a vital weight-bearing function every day. If you’re going to have surgery, make sure it’s for the right reasons.” Unfortunately, the prospect of wearing attractive shoes is not a good enough reason to go under the knife. 
How to Take Care of Feet With Morton’s Toe
Morton’s toe can lead to different kinds of foot issues, such as calluses or corns on the tip of the toes that rub against the front of shoes. Wearing tight shoes can turn the longer second toe into a hammertoe, when the toe curls inward. In general, this foot structure can lead to toes looking red and swollen when pushed into ill-fitting shoes. A bunion on the big toe can make it look shorter than the second toe, creating the appearance of Morton’s toe.
Fortunately, there are easy ways to prevent foot pain. These include:
- Wearing well-fitted shoes with good support
- Avoiding pointed shoes and opting for ones with a wide tip
- Wearing insoles with arch support
- Padding areas in the shoes that rub against the feet
- Taking care of calluses by regularly smoothing and moisturizing them
Remember, Morton’s toe isn’t a disease; it’s considered a normal foot shape, but it can cause pain and complication for some people. While conservative treatments often fix these issues, toe shortening surgery is sometimes required. Always consult with a medical care professional before beginning any kind of invasive treatment plan. 
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