Splint to straighten Toe

Q. I am a 55 yr old man, weight normal for height (5'11" 170) As a Brother in an Order for the last five years, my footwear consists only of made-to-order leather sandals with excellent arch support worn on otherwise bare feet.

Prior to this, I'd had problems buying properly fitting shoes due to being a "B" width and apparently men's shoes for the US market come in "C" or "D" widths. Consequently I sometimes had purchased shoes a half size smaller so they wouldn't be too wide and loose.

Ironically over the last two years when I have not worn shoes, the "knuckle" of the second toe on one foot has become enlarged and "knobby" and the toe is crooked. I have been using a toe splint which flattens the knuckle and straightens the toe somewhat so it does not look bad.

The toe is sometimes painful after several hours with the splint (too tight?) but doesn't hurt otherwise. However the "knuckle" appears to be getting a bit worse and, since our sandals are quite "open", the toe looks rather poorly without the splint.

Are there non-surgical treatments for this that would actually straighten the toe without having to wear the splint? If surgical treatment is the only option, would it require hospitalization? Can it be performed with a local or non-general anesthetic? How much "down" time is usually involved? Thanks.

A. Splinting alone may straighten the toe only temporarily.

Since the toe is straightened with the splint it sounds as though the toe is flexible. If still flexible, there may not be arthritic changes in the joint. Although, an x-ray would be necessary to rule this out.

If there is no arthritic change then the toe could possibly be straightened by an office procedure.

Even with arthritic changes the toe could possibly be straightened in a surgery center, on an outpatient basis.

Anesthetic used and time required to heal would depend on the amount of work necessary and any other medical conditions.