Digital deformities – Mallet Toe / Claw Toe / Hammer toe

What are digital deformities

Digital deformities are changes in the normal alignment of the toe. They are named after the joints that are affected.

A  Clawed Toe involves dorsiflexion of the proximal phalanx on the lesser metatarsophalangeal (MTP) joint and flexion of the proximal interphalangeal (PIP) and distal interphalangeal (DIP)

A  Mallet Toe  does not involve any deformity of the proximal phalanx on the lesser metatarsophalangeal (MTP) joint or proximal interphalangeal (PIP) joint. Typically, the only joint affected is the distal interphalangeal (DIP) joint which is flexed.

A  Hammer Toe sometimes involves dorsiflexion of the proximal phalanx on the lesser metatarsophalangeal (MTP) joint and flexion of the proximal interphalangeal (PIP). Typically, the DIP joint is extended or neutral in a hammer toe.

Causes of digital deformities

Biomechanical abnormalities

Small intrinsic muscles in the foot usually maintain the the toe in a straight position
When the long extrinsic muscles that work harder than the small intrinsic muscles the toe starts to claw.

	Causes of biomechanical abnormalities
	Inflammatory conditions like rheumatoid arthritis Tight poor fitting shoes High arched (pes cavus) foot Diabetes Old age Neurological conditions causing imbalance (Stroke, Charcot Marie Tooth, Cerebral palsy)

Complications of digital deformities

• Corns and callous
• Toenail pain
• Ulcers and wounds

Treatment of digital deformities

• Silicon padding and sleeves
  

• Taping
• Shoe stretching and modification
• Surgical release and re positioning of the digit
• Percutaneous tenotomy is a permanent way to fix the alignment of the toe click for more information Flexor Tenotomy

Before tendon release	After tendon release

The Foot and Ankle Centre’s Northcote Podiatrists can help you with all lower limb complaints, including Digital Deformities. Make an appointment to get your foot and ankle pain under control or contact us if you have any questions.