Claw- and hammertoes
Definition
A hammertoe is characterized by hyperextension of the metatarsophalangeal and distal interphalangeal joint and flexion deformity of the proximal interphalangeal joint. Clawtoes have flexion deformity in both interphalangeal joints.
Causes
Etiologies of lesser toe deformities include a foot with a second ray longer than the first, MTP synovitis and instability, inflammatory arthropathies, neuromuscular conditions, and ill-fitting shoe wear.
Symptoms
Pain, complaints with toenails, callosities, and difficulties in wearing closed and tight shoes.
Prevention
Orthotic devices, shoes with great toe boxes, strengthening of the foot muscles, passive range of motion excercises.
Surgical Procedures
Usually it takes more than one procedure to obtain complete and permanent correction of the deformity. The result must be a straight toe which touches the ground. This increases the contact surface, improves coordination and proprioception (see photograph hammertoe).
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