A claw toe is a misalignment of the toes that mainly affects the little toes. It is not as common as deformity of the big toe(hallux valgus) or hammer toe.
Claw toe is related to swan neck deformity. This is a curvature of the toe or finger joints caused by tendon damage.
The small toes have three joints:
Claw toe is the term used to describe
This position makes the toe appear to be curved like a claw.
The anatomy of the foot © bilderzwerg / Fotolia
A claw toe is almost always not congenital. It develops in the course of adult life in connection with superordinate foot deformities such as
A claw toe also develops with paralysis and individual nerve diseases. In addition, orthopaedically unsuitable footwear (high heels) is thought to cause the disease.
Claw toe is increasingly problematic from an aesthetic point of view if it is severe enough. Clinical complaints are often caused by pressure points : The curved toe no longer fits properly into the footwear and calluses and pressure points (corns) form in particularly exposed areas. This leads to severe pain and sometimes inflammatory complications.
A claw toe can often be corrected by conservative treatment of the underlying foot deformity. The prerequisite for this is that the claw toe deformity is not yet contracted, i.e. stiffened.
Conservative orthopaedic procedures include the use of
Toe exercises can be helpful. The footwear must be wide and soft.
Unfortunately, the treatment results of such conservative procedures are often unsatisfactory. Contractual deformities are not amenable to conservative procedures anyway. Attempts to treat corns or pressure calluses with appropriate ointments or local excision without treating the cause of the deformity are completely pointless.
A pronounced claw toe deformity is often treated surgically. Contraindications for this are incomplete bone growth and severe arterial circulatory disorders.
Comparison of the position of a healthy toe compared to a claw toe deformity © rob3000 | AdobeStock
The best-known surgical method is the so-called Hohmann operation. The principle of this procedure is the permanent correction of the deformity by
Technically, about a third of the metatarsophalangeal phalanx is removed on the joint side of the metatarsophalangeal joint. This is often possible under regional anesthesia instead of general anesthesia.
Depending on the intraoperative findings, the often shortened extensor tendon can also be lengthened . Sometimes a capsular release of the metatarsophalangeal joint is also necessary. The actual correction of the deformity is then easy to perform.
The result is secured by a stabilizing wire inserted over the entire length of the toe up to the metatarsal bone. After two to three weeks, sufficient scar stabilization occurs and the wire can be removed. During this time, a so-called forefoot relief shoe, i.e. a special bandage shoe, is worn.
The patient can then quickly switch back to normal footwear.
Alternatively or additionally, bony fusion of the affected joints (so-called MTP or PIP arthrodesis) can be performed. This is particularly useful for severe contractures.
The prognosis is good if the medical team not only treats the claw toe itself, but also its cause. In most cases, a misalignment of the entire forefoot is the cause or occurs in conjunction with claw toe.
Patients usually get rid of their symptoms permanently and are no longer impaired in their everyday life. In the vast majority of cases, typical recreational sports can also be practiced again without any problems.
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