What are the common toe deformities?
The most common toe deformities are hammer toe, mallet toe, claw toe and curly toe. Of these hammer toe is the most common type of deformity.
What are the symptoms?
- The most common symptoms are pain over the top and tips of the toes generally caused from rubbing on shoe wear. Over time hard skin or callus can form over the knuckles of the toe causing more pain and disability.
- In more advanced cases the toe deformity can cause the ball of the foot to become painful (metatarsalgia) and calluses can develop there too.
What are the causes?
- The most common cause is shoe wear which put excessive pressure on the toes and can cause them to bend to fit in the shoe.
- They are frequently found in association with problems of the big toe, such as bunions, which can cause forefoot crowding and more force to go thru the other toes. The toes can then deform as a result.
- The second toe is the most commonly affected- particularly in hammer toe deformity. This is because of its proximity to the big toe and the effect of bunions. Deformity of the second toe is sometimes caused by an underlying overly long second metatarsal.
- Claw toes which tend to affect multiple toes simultaneously may signify an underlying neurological condition particularly when associated with a high foot arch or cavovarus foot.
How are they diagnosed?
The diagnosis is generally fairly straightforward. A single consultation with a Consultant Orthopaedic Foot & Ankle Surgeon and routine standing x-rays of the foot tend to be all that is required. The X-rays are used to look for associated foot problems such as arthritis, a long second metatarsal or signs of joint subluxation.
Can they become worse?
Some people with these toe deformities have little or no symptoms. Unfortunately for many people they cause pain and disability. If you decide to not seek treatment the problems may progress, although usually quite slowly. With time the deformities can become more severe and rigid. Once the deformities become rigid it can mean that surgery is more likely to require bony corrections rather than just soft tissue corrections.
How can they be treated?
Non-operative treatment: the aim is to accommodate the toe deformity in a shoe that fits comfortably. There are also a variety paddings, splints and special insoles that can be used.
Surgery: the aim is to permanently correct the shapes of the toes themselves so they can fit comfortably in shoe wear.