Green’s Dictionary of Slang

a fight, a brawl.

1985		S. Berkoff West in Decadence and Other Plays (1985) 93: The occasional toe to toe with hard-faced Arthur.
1986		R.G. Barrett Real Thing 164: Do you think you can make it to the bar [...] without getting into another toe-to-toe with George?
2009		L. McIlvanney All the Colours 193: [T]he debonair street-fighter, [...] who still liked nothing better than a spot of toe-to-toe.