Claw toe:

A “claw toe” and a “hammer toe” are both deformed toes that can result from various causes. Here are their definitions:

  1. Claw toe: A claw toe is a toe abnormality in which the joint between the first and second phalanx of the toe is overextended, while the joint is flexed between the second and third phalanges. This makes the toe look like a claw. This can be caused by a variety of causes, including genetic predisposition, footwear that compresses the toes, or foot deformities such as a high arch.
  2. Hammer toe: A hammer toe is another toe abnormality in which the joint at the end of the toe (usually the second joint from above) is flexed, while the joint at the base of the toe remains normal. This makes the toe look like a hammer. As with the claw toe, footwear and genetic predisposition can play a role, but other factors such as injuries or neurological problems can also lead to it.

Both conditions can cause discomfort such as pain, friction, pressure sores, and difficulty walking. In some cases, treatment may be needed to relieve symptoms or correct the deformity. In most cases, only surgery can be promising.

Diagnostics:

The diagnosis of a hammer toe is usually made through a clinical examination by a doctor, typically an orthopedic surgeon or a podiatrist. Here are some steps that can be taken when diagnosing a hammer toe:

  1. Medical history: The doctor will talk to you about your symptoms, including any pain, discomfort when walking, and other problems related to your toes.
  2. Physical exam: The doctor will examine your toes and feet to assess the shape and alignment of the toes. They will look for signs of deformities, swelling, redness, or other abnormalities.
  3. Movement tests: The doctor may perform various movement tests to check the ability of your toes to move. These include tests to assess the flexibility of the affected toe and to determine if you have difficulty straightening or bending the toe.
  4. X-ray: an X-ray of the affected toes is done to assess the exact structure of the bones and rule out other possible problems, such as arthritis or fractures.

Based on the results of these examinations, the doctor can make a diagnosis and recommend appropriate treatment.

Therapy:

Therapy for claw toes depends on the severity of the deformity and the symptoms associated with it. Here are some possible treatment approaches:

  1. Adjusting footwear: Using shoes with enough space in the toe area can help reduce pressure on the toes and relieve discomfort. Wide, comfortable shoes or special shoes with deep toe boxes can improve symptoms.
  2. Physical therapy: Physical therapy exercises can help improve toe mobility and strengthen muscles, which can relieve symptoms.
  3. Toe extensors: Special devices that gently straighten the toes can help correct the deformity and relieve discomfort.
  4. Surgical interventions: In severe cases where conservative treatments are not sufficient, surgery may be considered. Surgical procedures can correct the tendons and soft tissues around the toe to restore normal alignment.

The choice of therapy depends on individual factors such as the severity of the deformity, the presence of symptoms such as pain or difficulty walking, and the patient’s personal preferences. It is important to consult a podiatrist to receive appropriate treatment tailored to specific needs.

Surgical technique:

The choice of technique depends on the severity of the deformity, the condition of the soft tissues and other individual factors. Here are some commonly used surgical methods:

  1. Toe joint resection (arthroplasty): In this operation, the base phalanx of the toe is reduced in its total length to reduce the pulling/contracture of the soft tissues/tendons. This allows for improved mobility and realigns the toe.
  2. Tendon lengthening (tenotomy): This technique involves lengthening shortened tendons that contribute to the curvature of the toe to restore normal alignment.
  3. Soft tissue and bone resection: In this method, excess soft tissues and bone fragments are removed to correct the deformity and realign the toe.
  4. Fusion (arthrodesis): In some cases, fusion of the affected toe joints may be necessary to correct the deformity. In this technique, the joints are fixed in such a way that they fuse together and achieve a stable, straight alignment.
  5. Soft tissue correction: This surgical technique involves correcting soft tissue structures around the toe, including the tendons, ligaments, and muscles, to improve alignment and correct deformity.

An experienced orthopedic surgeon with a subspecialization in foot surgery can recommend the best surgical method based on the patient’s specific situation. It is important to discuss all the risks and benefits of the surgery in advance.

Can a claw toe re-form after surgery?

No. If the procedure was carried out correctly then the deformity can no longer occur

Aftercare:

Full weight bearing in the bandage shoe for 6 weeks while limiting the rolling movement of the forefoot