In milder cases the deformity is simply cosmetic and surgery is not recommended. Care should be taken to ensure children are not wearing tight or ill fitting shoes which will exascerbate the deformity.
The development of sores or blisters is a relative indication for surgery. Providing the deformity is not rigid (the toe can be manually straightened)the simplest solution is to divide the tight tendon. This minor operation is performed through a small incision an the base of the toe. It is preferable to wait until the child is at least 4 years old to minimize the risks of damaging the small nerves and blood vessels that run along the toe. The operation is done as a day case. There is no need for a plaster cast and patients are advised to keep weight off the front of the foot for about 7-10 days. Dissolvable sutures are used.
In older children (more than 12 years) the deformity may be rigid. In these circumstances the deformity can only be corrected by removing the middle (proximal interphalyngeal) joint from the toe. The toe is then fused using a temporary wire that is passed along the toe. This is then removed after about 6 weeks. Movement is retained at the base of the toe and the functional result is usually excellent.