Common Toe Deformities You Should Know

Your feet are incredibly complex structures that contain one-quarter of all the bones in your body. Each foot has 26 bones, 19 muscles, and 107 ligaments. With so many components in your feet, it’s no surprise that deformities can easily form. These are often the result of shoes that are too short or tight. High heels cause a great number of toe deformities as well, which is why these conditions are typically more common in women than in men. 

Here are some deformities that you should be aware of so you can diagnose them early on and seek help from your Chicago physician before the issue worsens.

Claw Toe

person holding black stiletto heels
Image via Unsplash by andrewtangelao

Claw toe is a deformity where one or more of the lesser toes are bent into a claw-like shape. The toes typically bend upward from the joint at the ball of the foot and downward from the middle joint. The toes may also bend downward from the top joints and curl beneath the foot. This condition often leads to the development of corns, blisters, and calluses. There are many possible causes of claw toe, including:

  • Poorly-fitted shoes.
  • Nerve damage that weakens foot muscles, often from conditions like diabetes or alcoholism.
  • Heredity.
  • Osteoarthritis or rheumatoid arthritis.
  • Polio and cerebral palsy.
  • Stroke.
  • Spinal cord tumors.
  • Charcot-Marie-Tooth Disease.
  • Trauma to the foot.

Claw toe will worsen over time without treatment. Treatment options include splints, strengthening and stretching exercises, and surgery. Surgical treatments vary depending on whether the claw toe is flexible (in the early stage) or rigid (in the late stage). Options include tendon rerouting or lengthening, shortening of the phalanx bones, toe fusion, or the insertion of a steel pin.

Wearing proper footwear can help prevent or treat this condition as well. It’s best to choose shoes with minimal seams, a spacious toe box, low heels, and good arch support.

Mallet Toe

Mallet toe is a condition that occurs when the flexor digitorum longus (FDL) becomes too tight, causing the last toe joint nearest to the toenail to bend upward. Mallet toe is most common in the second toe, as this is usually the longest toe. This is a progressive condition that begins with a slightly bent toe that’s still flexible and may worsen into a rigid toe that will not straighten, even with outside force. The sooner you seek treatment for mallet toe, the better, as you can address the condition before it reaches this more progressive state.

Mallet toe is caused by repeated upward force on the toe that may come from:

  • Injury.
  • Ill-fitting shoes.
  • Arthritis.
  • Bone and muscle imbalances.

Mallet toe can become very painful. The bent toe often forms corns or blisters and can make it difficult to balance and walk. In early stages, mallet toe is often treatable with physical therapy. If movement has become permanently restricted, you may need surgery for mallet toe. Your surgeon can release the tendon and may also remove a small piece of bone to shorten the toe. Pins and rods are often used to hold the toe in place as it heals. Toe joint fusion is sometimes used in extreme cases.

Hammer Toe

Hammer toe is similar to mallet toe, but it affects the middle joint rather than the last joint of the toe. Hammer toe causes this joint to bend upwards. Though you might be able to flex the toe initially, hammer toe can progress to full rigidity. Corns, blisters, and calluses often form where the toe begins to rub against the shoe. This condition can make it painful to walk, particularly in shoes.

Hammer toe is often caused by shoes that are too narrow and tight, forcing the toe into this unnatural position. Rheumatoid arthritis increases your risk of developing hammer toe. Switching to roomy footwear can provide an effective treatment for hammer toe if this is done before the toe becomes completely inflexible.

In extreme cases, hammer toe can be treated surgically. This surgery will remove injured or deformed bones, reposition the toe, and properly align the joints and tendons.

Adductovarus Toe

Adductovarus toe is a condition where one toe moves beneath the other. This is most commonly seen with the fourth and fifth toes. This is caused by wearing shoes with a tapering toe box that forces the toes inward. It’s seen in varying degrees in many shoe-wearing people but is often too minor to require treatment. Adductovarus toe may occur alongside other toe deformities or as the result of some toe surgeries.

Hallux Limitus

Hallux limitus is a condition in which the joint between your foot and big toe becomes stiff, inflamed, and painful. This causes limited movement in the joint and can make it painful to walk. The condition may progress into hallux rigidus, which makes it impossible to move the big toe. Bone spurs and arthritis may also develop in the big toe as a result of hallux limitus. Some causes of hallux limitus include:

  • Abnormal foot anatomy in the metatarsal joint or metatarsal bone.
  • Injury.
  • Gout, rheumatoid arthritis, or osteoarthritis.
  • Poorly-fitting footwear.
  • Activities that cause repeated pressure on the toes.

Hallux limitus is treated with supportive footwear that keeps the toe from bending and does not place pressure on the big toe. A soft gel pad or custom orthotics can also help treat hallux limitus. Surgery is rarely attempted unless the condition progresses to hallux rigidus.

Retracted Toe

Retracted toe is a condition where the end of the toe is raised and does not contact the ground when walking or standing. This is similar to claw toe, but a claw toe may still make contact with the ground. Retracted toe can lead to many complications, including bursitis, ulceration, and infection. Retracted toes are often caused by:

  • Flat or highly arched feet.
  • Heredity.
  • Bunions.
  • Rheumatoid arthritis.
  • Poorly-fitted footwear.

Properly fitting shoes can help treat retracted toe. Silicone tubes or specially molded silicone props can help reverse retracted toe as well. In some cases, surgical treatment like arthroplasty is required.

If you’re suffering from toe deformities, seek qualified podiatric care as soon as possible. The earlier you address toe problems, the easier they are to fix. When Dr. Schoene is able to catch these problems early, she may be able to avoid surgery and succeed with a less invasive treatment option. 

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