What are the common deformities of the lesser toes?
The most common deformities affecting the lesser toes are- Hammertoes, mallet toes, and claw toes.
What is a Mallet toe?
Mallet toe deformity is characterized by a flexion deformity of the Distal Interphalangeal joint (DIP joint) of the toe. It usually involves the longest lesser toe. It could be due to a congenital or developmental anomaly. The most common cause of an adult onset mallet toe is due to lack of room for the longest toe in the shoe. (Fig 10.21)
What is a Hammer toe?
Hammer toe is characterized by flexion deformity of the Proximal Interphalangeal (PIP) joint. Due to pressure by shoes, there is a callosity at the PIP joint. It can affect one or more toes. It is most commonly caused by mechanical factors such as flexion of the toe from an ill-fitting shoe or crowding from a significant hallux valgus deformity. (Fig 10.22)
What is a Claw toe?
Claw toe deformity is defined as a toe where the primary deformity is a hyperextension deformity at the MTP joint. There is often a PIP joint flexion deformity as in hammer toes, but this is thought to be a secondary deformity. Claw toe deformity is usually can be …show more content…
The most common cause is disparity in length of metatarsals. This could be due to either congenitally long 2nd/3rd metatarsal or a shortened first metatarsal (following surgery of first ray). The other important cause is synovitis of MTP joint leading to subluxation or dislocation of MTP joint. This could be due to an inflammatory pathology, trauma or secondary overload caused by a dysfunctional first ray. The soles should be inspected as in severe cases there are visible callosities. Insoles (anterior arch support, metatarsal bar or metatarsal pad) are the first line of treatment. Surgical treatment in form of metatarsal osteotomy could be considered in reluctant cases. (Fig 10.24 a &