A recent photo of rock star and American Idol judge, Steven Tyler, walking on the beach reveals a rather unflattering deformity of his 2nd toe.  The 2nd toe is crossed over, lying on top of his great toe.

So what causes this sort of problem and how did it happen?  Tyler had bunions of both feet, at least one of which was surgically corrected in the Spring of 2008.  What developed, either before or after the surgery, is an instability and severe contracture of the 2nd toe.  Frequently the second metatarsal bone is longer than the 1st metatarsal, causing the ball of the 2nd toe to bear more weight than the others when walking.  Inflammation of this joint can frequent develop, causing pain in the ball of the toe.  Over time, if this inflammation continues, the joint tissue on the bottom of the foot can stretch, eventually causing a hammer toe.  When a bunion is present, there is even more pressure under the ball of the 2nd toe, making the development of the toe deformity occur much faster.  Over time, the joint becomes unstable due to tearing or stretching of the capsule on the bottom of the ball of the toe, and the toe begins to drift over on top of the great toe. 

If this deformity is identified and addressed at the same time as a bunion, the progression of the deformity can be minimized; and as we can see in Mr. Tyler’s condition, if left untreated, it can get worse even after bunion surgery.  When the deformity gets to this stage, surgery is necessary to repair the tissue on the bottom of the joint and stabilize and straighten the toe.  Overall the success rate is very good, although the one common problem following surgery is the inability of the toe to “rest perfectly on the ground” when standing.  This may make gripping a flip flop or sandal difficult.  If you have toe deformities or a bunion, they are easier to address when they are not as severe, with the outcome much more predictable.  Call us with any questions about your foot pains or deformities, so YOU don’t have to “WALK THIS WAY.”