Long Second Toe (Morton's Toe)
Morton's Toe, otherwise known as having a long second toe, is a foot deformity where a person's second toe is longer than their big toe, the Hallux; it is simple to recognize. According to experts, when looking at a person's foot, you would realize that the first toe is usually the longest as well as the largest. The remaining toes are shorter and smaller, decreasing proportionately in size. With a foot exhibiting Morton's Toe, the first toe may be either equal in length or somewhat shorter than the second toe. Since having a longer second toe is hereditary, it is found just as much in woman as it does in men. While only about 10 percent of the world populations are born with Morton's toe, about 80 percent of those with it suffer from chronic pain. Since having a longer second toe is hereditary, it is found just as much in woman as it does in men.
Dr. Dudley Morton, Father of Morton's Toe, wrote extensive articles on the repercussions of having a long second toe; he claimed that it can result in the following: back, knee, and hip pain, arthritis, fibromyalgia, bunions and hammer toes, and temporo-mandibular joint pain. Morton's Toe is a genetic factor; it is not linked to any particular ethnic group. However, it is often unofficially known as having the "classic Greek foot." In the 1900s, the long second toe was found more frequently in areas considered to be Celtic, such as Scotland and Ireland. There are stories stating that having a long second toe has come from farmers, as well as hunter gatherers; it is possible that the toe helped brace the person as they aimed their spear. Some often say that the Spanish biologically have Morton's Toe, although most of the ancient settlers of Ireland came from Iberia after the Ice Age leading into the Neolithic Ages. In addition, the English have AngloSaxon feet, which is considered to having the more "normal" big toe, with a wider spread. Anyone who may have a long second toe shares this distinction also share it with the Statue of Liberty!
The underlying cause for this condition could be multifaceted. The most common reason is usually due to a long proximal phalanx. Proximal phalanx is the first knuckle bone in the toes. When this bone is too long it will push the end of the toe out and that would lead the second toe to be longer than the first toe. The second most common problem could be a long middle phalanx. Middle phalanx is the middle bone in the knuckle of the toe. This would eventually lead the whole toe to be longer. The third most common cause could be due to a short bone in the big toe. This problem could be either due to a short metatarsal in the big toe or a short proximal phalanx or otherwise known as knuckle bone. This could be cause either due to a previous surgery or it could be due to genetic malfunction. A genetic malfunction could be that the bone never got as long as it was supposed to. Sometimes when children have accidents in early age the growth plate could close early and the bone may not grow to the right length. This could lead to a short bone. The problem could also be caused by a long second metatarsal bone. There might be many more reasons for the second to toe to be longer but we will not discuss this here.
When the second toe is longer than the first toe, the parabola that is formed by the toes will not function normally. This means excess pressure is placed on other toes. This could lead to pain at the bottom of the foot. If there is pain at the bottom of the foot the problem could cause a painful callus or metatarsalgia or otherwise known as inflamed bone. Or it could lead to irritation at on top of the toe. The irritation could be red and painful as seen in some of these pictures. If the irritation happens over a long period of time it may lead to contracture of second toe or forming of thick skin on top of the toe. The thick skin or otherwise known as corn could be painful or it may be just unsightly. Dr. Ravaei has encountered many patients who have resorted to "bathroom surgery" to try to get rid of this disfigurement. Other patients whose condition is not so severe place make up on the corn to make it less noticeable. Other patients have placed corn pad on the corn. When these corn pads have acid it will lead to a burn on the skin. The corn pad many times leaves a mark that is worst than the original corn. There are also those who wear bigger shoe to avoid the shoe rub.
Often, the condition may be unknowingly serious, as it can cause pressure on the top of the metatarsal (the ball in the back of the second toe). The metatarsal bones will usually push against the skin, causing bumps to emerge behind the toes. Patients with Morton's toe usually develop calluses behind the second toe and on both the inside and outside parts of the foot where the toes are connected.
Treatment
In some cases, wearing the proper footwear can help manage the condition of Morton's toe. In addition, wearing appropriate foot orthotics that feature arch support may help keep the foot aligned, However, Dr. Ravaei has met with patients that have pain that does not subside even after switching to more comfortable footwear. Therefore, the surgical correction for this problem involves shortening the toe. It generally leaves little to no scars on the foot.
If there may be an underlying problem such as arthritis, pain, or discomfort wearing shoes, insurance covers the procedure. Additionally, Dr. Ravaei delightfully offers the patient a free initial consultation in order to provide the appropriate treatment method to suit the patient's needs. He also provides custom made orthotics, also known as shoe insert, which cost close to $400. After many years of experience, Dr. Ravaei is very accustomed and proficient with taking the appropriate strategies and methods in order to treat each patient individually.
When all else fails, there are surgical treatments to correct this condition. The surgical condition may be lengthening of the first toe by different means. Or it may be shortening of the second toe by different means. The recovery for this procedure is usually fast but depends on the patient's health, age and activity level. Most patients are pleased by the look of their feet after surgery as well as the way they feel and resolve of pain.
