The forefoot is affected less frequently than the hindfoot in rheumatoid patients but comes to surgical reconstruction more frequently.

The classical rheumatoid deformities of hallux valgus and clawed lesser toes are made more painful with destructive arthritis, plantar prominence of metatarsal heads and callus formation.

Rheumatoid forefoot reconstruction has not changed dramatically over the last three decades and has been reliably efficacious.

However subtle technique changes and implant improvements have helped to keep this operation reproducible and beneficial for rheumatoid patients.