Cicero Podiatrist | Cicero Newsletter | IL | Luis E Mendoza, DPM |

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Luis E. Mendoza, DPM

(708) 780-8661

Cicero and Chicago 


Newsletter

 

Toe Deformities


Toe Deformities

Hammers, claws, and mallets; they sound like the goods at a hardware store, but may actually refer to people’s toes. There are three joints in our toes: the metatarsophalangeal joint, where the toe meets the foot, the proximal interphalangeal joint, where it bends in the middle, and the distal interphalangeal joint, where it bends at the tip. If a person wears overly tight shoes or suffers from certain medical conditions, any of these joints can become overly stiff. This causes not only pain but problems for the skin and gait.

Consequences of Deformity

If a person is suffering from nerve damage, they may not realize they are having trouble uncurling their toes without doing a visual inspection. But for the most part, claw toes and their ilk are sore from constantly rubbing against the patient’s shoes. They often develop corns and calluses, which can make them difficult to clean. People with neuropathy may not even notice that they have developed ulcers. Toe deformities happen gradually, so when patients see us, their toes are often still somewhat mobile. But without intervention, they could become permanently stuck.

Types of Deformities

A stuck distal joint results in a mallet toe. It commonly occurs in whichever of the patient’s toes is the longest. In people with hammertoes, the metatarsophalangeal joint is bent upwards, causing the toe to rise before bending down at the middle joint. A claw toe occurs when bending all three joints. Treatment for the different deformities may be similar, but podiatrists will still ask patients questions about their development in an attempt to better understand the problem. People with high arches or who walk with their feet point inward are particularly vulnerable to developing claw toes.

Although toe deformities can be congenital, they are usually due to the tendons and ligaments in the toes tightening over time. This is most commonly due to the toes being constricted by tight shoes that force the foot forward. Medical conditions like arthritis, stroke, and neuropathy related to diseases such as diabetes, alcoholism, Charcot-Marie-Tooth disease, and polio may also be to blame.

Treatments

In the time between making an appointment and visiting a podiatrist, a patient may try taping a deformed toe down. This is done by gently wrapping the tape around the problem toe and the adjacent ones (the conditions discussed in this article don’t affect the big toe). Much of our immediate concern will be with the patient’s footwear. Even if it isn’t causing the deformity, insufficiently large toe boxes will make chafing worse. We can remove hardened skin growths; patients attempting to cut corns themselves risk injury and infection. After treatment, we can provide orthotic devices.

Surgeries exist for toes that have become hardened, but they are usually unnecessary for ones that are still flexible. Patients should partake in strengthening and flexing exercises, such as picking up towels or marbles with their toes. They may also be given a longer-lasting and skin-friendly splint. When surgery is recommended, a podiatrist may manipulate shortened tendons or fuse toe bones together after removing damaged joints. Straightening a toe may only require a temporary pin insertion.

 


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