Possible causes include:
- Brachydactyly, a genetic disorder in which the individual phalanges do not grow to full size.
- Brachymetatarsia, which is also a genetic disorder causing underdevelopment of one or more metatarsals. The given toe then seems too short.
- Hammer toe surgery that was very radical and the toe was shortened more than it was needed.
All these problems can be resolved surgically. Small bone transplant can slightly elongate the toes and metatarsals. For greater lengthening, so-called mini-distracters can be used, which stretch the bone for several weeks (as in leg lengthening surgery).
These surgeries are performed under general anaesthesia or local anaesthesia of the foot. After the surgery, it is necessary to wear special shoes for several weeks, sometimes even a few months, in order to relieve the operated area.