Twenty-seven patients with 30 crossover toe (COT) deformities of the second toe were evaluated. This deformity in the transverse and sagittal planes at the second metatarsophalangeal joint may be caused by hindfoot pronation. Compression of the lateral plantar nerve may produce incompetence of the second dorsal interosseous muscle and an increased extension-adduction pull by the lumbrical and first dorsal interosseous muscles. A surgical procedure for tenodesis is described to correct these deformities and restore the extrinsic-intrinsic musculotendinous balance at the second MTP joint. Our results are encouraging, with 83% good or excellent results. There was one recurrence.
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