Congenital Deformities

Common Toe Deformities

Toe Deformities - Signs and Symptoms

The most common toe deformities are Hammer toes, Claw toes, and Mallet toes.

All three share the following symptoms:

• Pain with ambulation while wearing shoes
• Difficulty finding properly fitted and comfortable shoes
• Painful corns and calluses : These are hard skin growths that result from pressure and
  rubbing from ill-fitting footwear
• Initially, the deformed toe is flexible. If left untreated however, it will become fixed and
  immovable requiring surgery.

Although symptoms are similar, the appearance of each type of deformity is different.

• Hammer Toes
• Claw Toe
• Mallet Toe

Hammer Toes With this deformity, the toe is bent at the middle joint causing a curling of the toe. It is most common in the second toe, but can occur in any toe. Hammer toes are often present along with a bunion, a painful outgrowth along the side of the foot at the base of the big toe.
Claw Toe This type of deformity involves an upward bending of the toe joint at the ball of the foot. At the middle joint and sometimes the end joint as well, the toes bend downward in a claw-like fashion, often digging in to the sole of the foot. It can occur in any toe except the big toe.
Mallet Toe This deformity is very similar to a hammer toe except the joint involved is the upper joint instead of the middle joint, giving the toe a mallet-like appearance at the end of the toe.

Toe Deformities - Conservative Treatment

Your physician will be able to diagnose your condition by examining the toes. No diagnostic tests are usually necessary unless your physician suspects nerve involvement in which case special tests may be ordered.

Conservative treatment measures are usually recommended before surgery is considered. The goals of conservative treatment include:

• Restore or maintain walking ability
• Pain Relief
• Decrease pressure and friction over bony prominences
• Delay the progression of the deformity

Your physician will assess your condition and may suggest the following treatments

• New shoes with a soft, high, enlarged toe area
• Avoid tight, narrow, and high heeled shoes
• Splints or tape may be applied to reposition the toes
• Cushions or pads applied to pressure areas to relieve pain and prevent skin breakdown
• Toe exercises may also be prescribed. These can include picking up marbles with your toes, crumbling a piece of paper with your toes and other stretching exercises

Surgical Procedure

Introduction

Surgical treatment of toe deformities may be recommended by your physician if conservative treatment measures fail to relieve your symptoms or if the toes are in a rigid, fixed and immovable position.

The goals of surgery are to restore normal toe alignment and return the foot to normal painfree function.

Surgical Treatment

Surgery to correct toe deformities is performed in a hospital operating room under local anesthesia with regional pain blocks and usually does not require an overnight hospital stay.

The type of surgery performed on toe deformities depends on certain factors. Your surgeon will consider the following:

• Age
• Extent of the deformity
• Medical history
• Physical condition
• Rigidity or flexibility of the toe

Surgical Procedure If some flexibility exists in the toe, your surgeon will make an incision over the deformed toe joint and realign the tendons and ligaments. Pins may be placed to keep the toe in position while healing. The incision will then be closed with sutures and covered with a sterile dressing.
If the toe deformity is rigidly fixed, your surgeon will make the incision over the joint of the deformity, realign the tendons and ligaments, and also perform an osteotomy which is the removal of bone pieces. Your surgeon will then insert pins to keep the toes in proper alignment during the healing process.

The incision will then be closed with sutures and covered with a sterile dressing.

Click the desired links below to find out more from American Academy of Orthopaedic Surgeons (AAOS) website.

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