MTP Joint Capsule Release for Clawtoe Deformity

Edited by Daniel Cuttica, DO


claw toe is a toe deformity that is contracted at the middle and end joints in the toe and can lead to pressure and pain in the toe. It is often associated with tightening and scarring of the joint capsule at the base of the toe. The toe will tend to extend upwards and over time, the tissue that makes up the top part of this joint lining (joint capsule) can become thickened and scarred. When this happens even if the toe is brought down into a more normal position, the claw toe can recur because of this scarred capsule. Therefore a formal release of this scarred capsule may be needed in order to aid the correction.

An MTP joint capsule release is typically used in more mild to moderate claw toe deformities that have a contracture of the joint capsule at the base of the toe.


Patients with multiple foot problems in addition to the hammertoe should avoid surgery for just the hammertoe alone. Other reasons to avoid surgery include active infection, poor circulation to the toes, and any serious illness that would make surgery unsafe.


An incision is made over the top (dorsal) aspect of the foot at the base of the clawtoe. This incision may also be used to perform additional procedures that may be needed to correct the claw toe. Next, the top aspect of the toe joint (metatarsal phalangeal (MTP) joint) is exposed. The thickened top part of the joint capsule is then cut (released). The joint capsule, both on the inside (medial) and the outside (lateral) are also often released to allow the toe to fall into an improved position. It may be necessary to stabilize the toe with a pin across the joint. This would be particularly necessary if the joint had been partially out of position prior to the surgery. This will often occur in patients with severe clawtoe deformities.


Recovery from the surgery is often dictated by the associated procedures that were required to correct the clawtoe. The actual recovery from this surgery is relatively quick and movement can be started once the incision has healed, after 10-14 days. If a pin was used, it is typically removed at 4-6 weeks after surgery, and motion exercises are started after the pin is removed. There are often other procedures such as a PIP joint fusion or a tendon procedure that will limit mobility of the toe for the first 6 weeks.

Potential Surgical Complications

Specific Complications

Complications that are specific to an MTP capsule release procedure are uncommon, but may include:
  • Stiffness
  • Scarring at the base of the toe can lead to stiffness.
  • Recurrence of the Deformity. If new scarring of the joint capsule occurs, the deformity can occur.

General Complications

In addition to the specific complications listed above there is the potential for the following general complications:

Edited on June 26, 2017


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