The accepted treatment of flexion contraction of the toes with its etiology is reviewed. Special emphasis is placed upon the importance of the deformity of the first toe and its sesamoid bone in causing the great disability. The transplantation of the extensor tendon of the fifth toe to the base of the first phalangeal bone is added to the routine procedure in order to secure dorsiflexion of the great toe with a more accurately balanced musculature.