|
|
Your Foot Book What Is a Claw Toe? Hammer toes, mallet toes, and claw toes are a very common lesser toe (toes 2 through 5) deformity that often is painful, and limits function and shoe wear selection. A claw toe is a deformity of the toe in which the MTP joint (metatarsophalangeal joint-the joint that joins the toe to the rest of the foot) is pulled up or extended. The mid toe joints (interphalangeal joints) are flexed, producing a toe that resembles a claw. (Fig. 1) A hammer toe is a deformity in which the middle interphalangeal joint (IPJ) is flexed. (Fig. 2) A mallet toe is a lesser toe deformity in where the end joint (distal IPJ) is flexed. (Fig. 3)
What Causes a Claw Toe? Claw toes, mallet toes, or hammer toes may be caused by trauma (stubbing your toe, and producing a fracture or tear of the tendons that straighten or extend the toe). More commonly, the deformity occurs slowly or chronically. Neuromuscular diseases such as cerebral palsy, polio, Charcot Marie Tooth disease, stroke, closed-head injury; or nerve injury or other rare, neuromuscular problems; can cause imbalance between the extensor tendons that straighten the toe and the flexor tendons that bend the toes. This tendon imbalance can result in a progressive claw toe deformity. Inflammatory conditions such as rheumatoid arthritis, gout , systemic lupus, enanthematousis, and Reiter's disease may cause inflammation of the toe joints (synovitis), and result in stretching or laxity of joint ligaments which allows the deformity to develop. People with a high-arch (cavus) type foot may be prone to develop claw toes. Finally, many people develop claw toes for no known reason (idiopathic - we don't know why). What Problems May Result From Claw Toes?
Treatment of Claw Toes Conservative treatment of claw toes consists of decreasing pressure on the toes. Keeping your skin moisturized is helpful in reducing friction. A roomy, comfortable shoe, with a spacious rounded toe box made with a soft flexible material, will help to decrease the pressure on the toes. Mild claw toe problems may be helped by silicone, or O-shaped corn pads or toe sleeves. A hammer toe strap might help to pull down and straighten a flexible claw toe. Over-the-counter orthotics or custom orthotic devices will help to decrease pressure on the ball of the foot and relieve metatarsalgia. Finally, surgery may be needed to straighten a severe claw toe deformity when conservative treatment fails. This material does not constitute medical advice. It is intended for informational purposes only. Foot Menders will not answer medical questions via email. Please consult a physician for specific treatment recommendations. |
Although
claw toes, hammer toes, and mallet toes are technically different,
they behave and look similarly, and will be discussed as one problem.
Claw
toes may be flexible (easily straightened) or rigid, with stiff
joints or tight tendons preventing correction. As seen below, a
claw toe deformity can cause increased pressure or friction on the
tip of the toe and over the top of the IP joints, due to rubbing
against the shoe toe box. When the toe cocks up, the metatarsal
bone is pushed downward, resulting in increased pressure under the
ball of the foot (metatarsalgia). This increased pressure can result
in a thick, painful callus underneath the ball (metatarsophalangeal
joint) of that toe. In severe cases of claw toe deformity, shoe
wear selection obviously can be severely limited.