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Hammer/Claw/Mallet Toe, Sports Medicine

Antonio Howard, MBBS, MSc, FAAPMR, CAQSM and Robert D. Martin, MD Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Toe joint deformities result from an imbalance between flexor and extensor forces about the interphalangeal (IP) and metatarsophalangeal (MTP) joints. Pain often results from abnorma...

DIAGNOSIS

HISTORY

  • Trauma

  • Personal or family history of neuromuscular disorder

  • Risk factors for peripheral neuropathy: diabetes mellitus, alcohol abuse, renal failure

PHYSICAL EXAM

  • Inspect for:

    • Toe deformity...

TREATMENT

GENERAL MEASURES

  • Patient education about shoe selection/modification—flat/low heel, wider, and taller toe-box and adequate length 1[C]. A good rule of thumb is, there should be a circumferenc...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

In the absence of any pressing surgical indication (e.g., acute trauma or competitive athlete), conservative treatment may be a long-term option given that the pa...

REFERENCES

1
Frey-Ollivier S, Catena F, Hélix-Giordanino M, et al. Treatment of flexible lesser toe deformities. Foot Ankle Clin.  2018;23(1):69–90.
2
Federer AE, Tainter DM, Adams SB, et al. Conser...

ADDITIONAL READING

  • Hagedorn TJ, Dufour AB, Riskowski JL, et al. Foot disorders, foot posture, and foot function: the Framingham foot study. PLoS One.  2013;8(9):e74364.

  • Hannan MT, Menz HB, Jordan ...

CLINICAL PEARLS

  • Remember: The joint will deform or pull to the strong (intact) side.

  • Injecting botulinum toxin to both the long and the short flexors of the toes is well tolerated and efficacious in th...

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