When a toe is permanently bent — a fixed hammer toe (proximal joint bent), claw toe (both small joints bent), or mallet toe (tip bent down) — and rubs in shoes or against neighbouring toes, the definitive correction is to remove a small amount of bone from the affected joint and fuse it straight. The joint stops moving, the toe is straight, and most patients find shoes immediately more comfortable. The two main fixation options are a temporary K-wire (passed through the toe, sticking out the end for 4–6 weeks, then removed in clinic) or an internal implant (a small permanent device that stays inside the bone). Each has trade-offs — K-wires are cheaper, simpler and well-evidenced but require an exposed pin; implants are tidier but cost more and very occasionally need removal if irritating. For fixed crossover toes with dorsal dislocation, the fusion is often combined with a metatarsal-head shortening osteotomy to reduce the load on the joint. Soft-tissue procedures (tendon transfers, capsular releases) are still right for flexible deformities — fusion is for the rigid ones.