Hammertoes/claw toes

Hammertoes or claw toes often occur as people age due to an inherent muscle imbalance and usually involves the 2nd and 3rd toes although all four lesser toes can be problematic.  This condition can make wearing restrictive shoes uncomfortable.  This condition may be associated with increased pressure exerted on the ball of the foot because the calf is tight, the recruitment of the toe extensors to pull the foot up or a combination of both.  Additionally, lessor toe deformities can occur as a result of a neuromuscular imbalance, Charcot-Marie-Toothe being one such coniditon.

Symptoms:
The most obvious symptoms of hammertoes / claw toes are the clawing of the involved toes is a progressive gooseneck or clinched alignment.  Pain, often associated with weight bearing.  Patients typically report feeling as though they are walking on pebbles or the sock is balled-up in their shoe.  wearing shoes may also result in pain, callus formation of ulceration to the top of the involved toes.  The deformity is usually supple, early on, meaning the toe can be straightened.  Later, as the deformity progresses the toes may become rigid.

Diagnosis:
The orthopedic surgeon, through a very thorough history and physical exam will evaluate the extent of the deformity. It is important to define the parameters which are influencing the problem and not just look at the toe. X-ray studies while weightbearing or helpful an identifying arthritic changes in the presence of bone spurs.
Treatment:
Treatment for hammertoes / claw toes depends on the symptoms and influencing factors.  Non-operative treatment includes wearing extra depth and extra width shoes, wearing custom orthotics with meta-tarsal pads.  And stretching of the calves. The aim of this treatment is to unload the ball of the foot and avoid pressure on the toes.  When conservative treatment fails, patients may improve with operative treatment.  There are several procedures that can correct this condition.  The goal of surgical management is to restore the alignment of the toes and their weight bearing function.  Your orthopaedic surgeon will determine the best procedure for you based upon their diagnosis

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