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Hammertoes and Claw Toes: Primary and Revision

  • Roberto A. Brandão
  • David Larson
Chapter

Abstract

Digital hammertoe and claw toe deformities of the forefoot remain a constant challenge to the foot and ankle surgeons daily. Patients often present with complaints of painful callosities on the dorsal or distal aspect of the affected digit with or without concomitant pain under the lesser metatarsophalangeal joints (MTPs). Digital contractures cause a retrograde pressure on the metatarsal heads leading to this “metatarsalgia” or plantar forefoot pain. The etiology is multifactorial and often treated nonoperatively with prefabricated or custom orthoses, padding, shoe gear modification, and taping. The lesser toe deformities can be associated with hallux abducto valgus deformities, pes plano valgus, neuromuscular disorders, and ankle equinus and can lead to pathologic plantar plate ruptures of the MTPs. When conservative management has failed, surgical intervention is necessary to provide adequate joint stability and pain reduction. The appropriate etiology and accurate diagnosis must be identified in order to provide the best treatment and surgical plan for each patient.

Keywords

Hammertoe Claw toe Lesser digital deformities Forefoot surgery Crooked toe 

Abbreviations

DIPJ

Distal interphalangeal joint

EDL

Extensor digitorum longus

FDL

Flexor digitorum longus

MTP

Metatarsophalangeal joint

PIPJ

Proximal interphalangeal joint

References

  1. 1.
    Bettin CC, Gower K, McCormick K, Wan JY, Ishikawa SN, Richardson DR, Murphy GA. Cigarette smoking increases complication rate in forefoot surgery. Foot Ankle Int. 2015;36(5):488–93.CrossRefGoogle Scholar
  2. 2.
    Boberg J, Willis JL. Digital deformities: etiology, procedural selection and arthroplasty (Chap. 13). In: Banks AS, Downey MS, Martin DE, editors. McGlamry’s forefoot surgery. Philadelphia: Wolters Kluwer Health; 2015.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Roberto A. Brandão
    • 1
  • David Larson
    • 2
  1. 1.The Centers for Advanced Orthopaedics, Orthopaedic Associates of Central Maryland DivisionCatonsvilleUSA
  2. 2.Steward Health Care, Department of PodiatryGlendaleUSA

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