Surgery of the lesser toes is a difficult balancing act, and revision procedures are challenging. It is vastly preferable that the correct procedure be chosen for the correct patient and performed properly from the outset. The flow charts below (Figs. 23–25) are not a rigid protocol, but rather the authors’ personal algorithm, based on their own experience, which may help other surgeons facing a stiff, deformed or flail toe to make a reasoned decision.