Toe deformities are caused by a variety of factors:
- Associated with a pes cavus deformity resulting from an underlying neurological condition – eg, Charcot-Marie-Tooth syndrome.
- Poorly fitted shoes – usually the result of wearing shoes that are too short. Many people have second toes that are longer than their big toes. If they wear shoes sized to fit the big toe, the second toe has to bend to fit into the shoe – causing mallet toe. High-heeled shoes with pointed toes are also a major cause of claw toes.
- Highly arched feet.
- Rheumatoid arthritis.
- Tendon imbalance. When the foot cannot function normally, the tendons may stretch or tighten to compensate, leading to toe deformities.
- Traumatic injuries of the toes.
This should include neurovascular evaluation and appreciation of muscle bulk/wasting.
Types of toe deformities
- Claw toe
- Hammer toe
- Mallet toe
These principles are applicable to all three conditions. Treatment of these conditions often includes shoe modifications, appliances, therapeutic exercises and surgical repair.
- Trimming, or wearing protective padding on, corns and calluses.
- Wearing supportive custom-made plastic or leather shoe inserts (orthotics) to help relieve pressure on toe deformities.
- Using splints or small straps to realign the affected toe.
- Wearing shoes with a wider toe box.
- Injecting anti-inflammatories to relieve pain and inflammation.