CROSSOVER TOE

What Is Crossover Toe? to dislocation of the joint, so it is Diagnosis rossover toe is a condition in very beneficial to have a foot and Crossover toe is sometimes mis- C which the second toe drifts ankle surgeon evaluate the foot soon diagnosed, especially in the early toward the big toe and eventually after pain first occurs. stages when there is pain but the crosses over and lies on top of the toe has not yet crossed over. The big toe. Crossover toe is a common What Causes Crossover Toe? pain experienced in crossover toe condition that can occur at any age, It is generally believed that crossover mimics a condition called Morton’s although it is most often seen in adults. toe is a result of abnormal foot neuroma. The two disorders, Some people confuse crossover toe mechanics, where the ball of the foot however, are treated very differently— with a hammertoe, probably because beneath the second toe joint takes an making it crucial to obtain an both conditions involve a toe that does accurate diagnosis. not lie in the normal position. However, In arriving at a diagnosis, crossover toe is entirely different from a the foot and ankle surgeon will hammertoe—and much more complex. examine the foot, press on it, and maneuver it to reproduce the Symptoms of Crossover Toe symptoms. The surgeon will also Although the crossing over of the look for potential causes and test toe usually occurs over a period the stability of the joint. X-rays are of time, it can appear more quickly usually ordered, and other imaging if caused by injury or overuse. studies are sometimes needed. Symptoms may include: • Pain, particularly on the ball of excessive amount of weight-bearing Treatment: the foot. It can feel like there’s a pressure. This pressure eventually Non-surgical Approaches marble in the shoe or a sock is leads to weakening of the supportive The best time to treat crossover bunched up. ligaments and a failure of the joint to toe is in the early stages, before • Swelling in the area of pain, stabilize the toe, resulting in the toe the toe starts to drift toward the including the base of the toe crossing over. big toe. At that time, non-surgical • Difficulty wearing shoes Certain conditions or character- approaches can be used to stabilize istics can make a person prone to the joint, reduce the symptoms, Crossover toe is a progressive dis- experiencing excessive pressure on and address the underlying cause order. In the very early stages—the the ball of the foot. These most of the condition. best time to treat crossover toe—a commonly include a severe bunion The foot and ankle surgeon may patient may have pain but no deformity,a second toe longer than select one or more of the following crossover of the toe. Without treat- the big toe, an arch that is structurally options for early treatment of ment, the condition usually worsens unstable, and a tight calf muscle. crossover toe: • Rest and ice. Staying off the foot • Taping/splinting. It may be inserts are often very beneficial. and applying ice packs help necessary to tape the toe so that it These include arch supports or a reduce the swelling and pain. will stay in the correct position. metatarsal pad that distributes Apply a bag of ice over a thin This helps relieve the pain and the weight away from the joint. towel to the affected area for 20 prevent further drifting of the toe. minutes of each waking hour. Do • Stretching. Keeping the calf muscles When Is Surgery Needed? not put ice directly against the skin. stretched is important in patients Once the second toe starts moving • Oral medications. Nonsteroidal who have tight calf muscles. toward the big toe, it will never anti-inflammatory drugs (NSAIDs), • Shoe modifications. Supportive go back to its normal position such as ibuprofen, may help shoes with stiff soles are recom- unless surgery is performed. The relieve the pain and inflammation. mended because they control the foot and ankle surgeon will select • Immobilization. Sometimes the motion and lessen the amount of the procedure or combination foot is immobilized for a while so pressure on the ball of the foot. of procedures best suited to the that the injured tissue can heal. • Orthotic devices. Custom shoe individual patient. ▲

This information has been prepared by the Consumer Education Committee of the American College of Foot and Ankle Surgeons, a professional society of 6,000 foot and ankle surgeons. Members of the College are Doctors of Podiatric Medicine who have received additional training through surgical residency programs. The mission of the College is to promote superior care of foot and ankle surgical patients through education, research and the promotion of the highest professional standards. Copyright © 2006, American College of Foot and Ankle Surgeons • www.FootPhysicians.com