Claw toes, like the hammer toes, are diffracted in the proximal intermediate joint but also in the distal intermediate joint. The deformity can be flexible or rigid - and the surgical treatment is done accordingly.
Analogous to the hammer toes flexible claw toes can be treated with tendon transfers and rigid claw toes with stiffening of the intermediate joint. However, this misalignment often makes it necessary to combine both methods.
Claw toes are toes bent in both the proximal and the distal intermediate link joint, but additionally exhibit a complete (luxation) or partial dislocation (subluxation) in the basal joint. Claw toes do not reach the ground and due to their position above the metatarsal head seem just like animal claws. They have lost their function during walking (no weight-bearing) and standing (no assistance in maintaining body balance).
About the surgery
Conservative measures do not help here. This deformity is operated.
First, the massively shortened flexor tendons must be extended. Is it possible to stretch the toe, then the proximal joint is straightened and fixed with a micro screw, similar to a hammertoe treatment. Sometimes additionally the distal intermediate joint also needs to be fixed. In particular ankylosed contortions (rigid dislocation), the metatarsal bone is also shortened slightly, so that the toe can be brought back into a congruent joint position (reduction).
We do not use any drill wires, even for this correction!
Activity can be resumed immediately. Walking is possible immediately after the operation, initially restricted and reduced to only what is necessary, but can be increased from the 2nd week onwards. Normal shoes can be worn after 2 to 4 weeks. In case of comprehensive corrections a swelling of the forefoot for about 3 to 8 weeks can be expected.
This foot has a claw toe at the II and III toe.
After surgery, both toes reach the ground, do not cause any more problems in the shoe and can bear weight during walking and running.
Click to enlarge the image.
Left: Claw toes and Splayfoot pain (at the heel, and ball area)
Right: After a joint-preserving shortening of the II, III, IV metatarsal and a toe stretching, the toes are straightened and the pain is gone
Dig V. varus superductus or little toe, which is situated above the fourth toe and is oriented upwards. The patient has already underone surgery elsewhere, however with no success.
Left: Prior to correctional surgery: fifth toe is oriented upwards
Right: Post surgery: nice straight toe
The other side was also a success.