Claw and hammer toes
There are three bones or phalanges in each one of the toes (except the big or hallux toe, which has two). The place where each bone connects with each other, is called joint. Normally the toes rest extended on the floor.
Due to pressure over the tips of the toes, genetic abnormalities, muscular imbalances and neurological pathologies, one or more of the joints can bend, and generate a deformity.
What is a claw or hammer toe?
Toes that present a deformity in one or both of its joints are called differently depending on the joint involved. The majority of these deformities have in common a flexion of the proximal interphalangeal joint (the first joint in each toe from back to front). If the flexion involves the distal interphalangeal joint (the second joint of the toe), the deformity resembles a mallet, and thus it is called mallet toe. If the flexion involves the proximal interphalangeal joint, the deformity resembles a hammer, and it is called hammer toe. If a hammer toe includes also a hyperextension of the metatarsophalangeal joint (the base of the toe), the deformity is then called claw toe.
Generally using too narrow or high-heeled shoe wear compresses the toes against the tip of the shoe, and promotes a deformity bending one of the joints of the toes. Normally these deformities will occur on the longest toes of your foot.
Signs and Symptoms
You may feel pain in one of your toes, or in the front part of your foot, also called forefoot. A callus can develop where the toe rubs against the shoe, either on top of the toe or under the tip of the toe against the sole of the shoe. These calluses can hurt too, and lead to ulcer formation.
Prevention
Keeping an adequate shoe wear with plenty of space for the toes helps prevent these deformities. In some cases these deformities develop after neurological conditions and muscular imbalances which cannot be prevented. Deformities can develop also in diabetic feet.
Diagnosis and Treatment
Your orthopedic surgeon will examine you and determine if you have any deformity or other disease. He will recommend you a specific treatment, which may consist in shoe wear modifications, insole use or other orthosis to try to correct the deformity. If the deformity is stiff or if there is no response to conservative treatment, a surgery will be recommended.
Surgery
This will consist in soft tissue procedures and osteotomies (procedures over bone) to correct the deformity and alleviate pain. Your surgeon will explain to you the surgical details, postoperative rehabilitation and possible complications.
-Clinica Alemana has foot and ankle surgeons trained in the U.S. and in Europe, which will offer you the best treatment and care for your condition.
-Brochure prepared by the Foot and Ankle team of the Orthopedics and Traumatology Department of Clinica Alemana.