The syndactylism procedure is an excellent surgical choice for the correction of an iatrogenically induced flail toe. Stability of the involved digit may be achieved and the return to normal shoegear may be possible. In the patient with a long-standing painful heloma molle between the fourth and fifth toes, a syndactylism combined with head resection of the fifth proximal phalanx may be considered the procedure of choice. This procedure most effectively eliminates the fibrotic tissue while maintaining fourth and fifth toe stability. With the modifications in the skin incision suggested above, a cosmetically aesthetic result may be achieved. Adherence to meticulous technique and good patient postoperative compliance help to insure good results.