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Toe deformity

MedGen UID:
508410
•Concept ID:
C0149662
•
Anatomical Abnormality
Synonym: Toe deformities
SNOMED CT: Deformity of toe (299567001)
 
HPO: HP:0034398

Definition

Abnormal positioning of toe phalanges. Deformities of the lesser toes often occur gradually, though they can be brought on by trauma. The main adult sagittal plane deformities consist of claw toes, hammer toes and mallet toes. Axial plane deformities include crossover toes. [from HPO]

Professional guidelines

PubMed

Guidelines on offloading foot ulcers in persons with diabetes (IWGDF 2023 update).
Bus SA, Armstrong DG, Crews RT, Gooday C, Jarl G, Kirketerp-Moller K, Viswanathan V, Lazzarini PA
Diabetes Metab Res Rev 2024 Mar;40(3):e3647. Epub 2023 May 25 doi: 10.1002/dmrr.3647. PMID: 37226568
Analysis of clinical manifestations and treatment in 26 children with fibrodysplasia ossificans progressiva in China.
Zhang JM, Li CF, Ke SY, Piao YR, Han TX, Kuang WY, Wang J, Deng JH, Tan XH, Li C
World J Pediatr 2020 Feb;16(1):82-88. Epub 2019 Sep 16 doi: 10.1007/s12519-019-00302-x. PMID: 31529313
Differential diagnosis of pedal osteomyelitis and diabetic neuroarthropathy: MR Imaging.
Ledermann HP, Morrison WB
Semin Musculoskelet Radiol 2005 Sep;9(3):272-83. doi: 10.1055/s-2005-921945. PMID: 16247726

Recent clinical studies

Etiology

Guidelines on offloading foot ulcers in persons with diabetes (IWGDF 2023 update).
Bus SA, Armstrong DG, Crews RT, Gooday C, Jarl G, Kirketerp-Moller K, Viswanathan V, Lazzarini PA
Diabetes Metab Res Rev 2024 Mar;40(3):e3647. Epub 2023 May 25 doi: 10.1002/dmrr.3647. PMID: 37226568
Lesser-toe deformity.
Darcel V, Piclet-Legré B
Orthop Traumatol Surg Res 2023 Feb;109(1S):103464. Epub 2022 Oct 29 doi: 10.1016/j.otsr.2022.103464. PMID: 36942795
Crescentic Osteotomy for Revision Hallux Interphalangeal Joint Arthrodesis.
Franklin A, McKee P, Claessens J
Foot Ankle Spec 2017 Apr;10(2):152-156. Epub 2016 Nov 30 doi: 10.1177/1938640016679699. PMID: 27903927
Percutaneous correction of congenital overlapping fifth toe in paediatric patients.
Murgier J, Knörr J, Soldado F, Bayle-iniguez X, Sales de Gauzy J
Orthop Traumatol Surg Res 2013 Oct;99(6):737-40. Epub 2013 Sep 7 doi: 10.1016/j.otsr.2013.06.002. PMID: 24016617
The combined hammer toe-mallet toe deformity with associated double corns: a retrospective review.
Oliver TP, Armstrong DG, Harkless LB, Krych SM
Clin Podiatr Med Surg 1996 Apr;13(2):263-8. PMID: 9118017

Diagnosis

Neuropathic Deformities of the Lesser Toes.
Wagner E, Wagner P
Foot Ankle Clin 2024 Dec;29(4):617-628. Epub 2024 Mar 11 doi: 10.1016/j.fcl.2024.02.001. PMID: 39448175
Lesser Metatarsophalangeal Plantar Plate Repair.
Hyer CF, Consul D, McAlister JE, Cottom JM
Clin Podiatr Med Surg 2022 Apr;39(2):167-185. doi: 10.1016/j.cpm.2021.11.008. PMID: 35365322
Percutaneous correction of congenital overlapping fifth toe in paediatric patients.
Murgier J, Knörr J, Soldado F, Bayle-iniguez X, Sales de Gauzy J
Orthop Traumatol Surg Res 2013 Oct;99(6):737-40. Epub 2013 Sep 7 doi: 10.1016/j.otsr.2013.06.002. PMID: 24016617
Toe deformity after pregnancy due to fibroma of tendon sheath: a case report and review of literature.
Ma X, Xu J, Wang X, Wang C, Zhang YJ
Orthop Surg 2013 Aug;5(3):225-8. doi: 10.1111/os.12056. PMID: 24002843Free PMC Article
Complications and salvage of elective central metatarsal osteotomies.
Derner R, Meyr AJ
Clin Podiatr Med Surg 2009 Jan;26(1):23-35. doi: 10.1016/j.cpm.2008.09.003. PMID: 19121751

Therapy

Percutaneous Techniques in Orthopedic Foot and Ankle Surgery.
Schipper ON, Day J, Ray GS, Johnson AH
Orthop Clin North Am 2020 Jul;51(3):403-422. Epub 2020 Apr 22 doi: 10.1016/j.ocl.2020.02.004. PMID: 32498959
Treatment of Rigid Hammer-Toe Deformity: Permanent Versus Removable Implant Selection.
Doty JF, Fogleman JA
Foot Ankle Clin 2018 Mar;23(1):91-101. doi: 10.1016/j.fcl.2017.09.007. PMID: 29362037
Crescentic Osteotomy for Revision Hallux Interphalangeal Joint Arthrodesis.
Franklin A, McKee P, Claessens J
Foot Ankle Spec 2017 Apr;10(2):152-156. Epub 2016 Nov 30 doi: 10.1177/1938640016679699. PMID: 27903927
Complications and salvage of elective central metatarsal osteotomies.
Derner R, Meyr AJ
Clin Podiatr Med Surg 2009 Jan;26(1):23-35. doi: 10.1016/j.cpm.2008.09.003. PMID: 19121751
Toe deformity from prolonged pulse oximetry.
Lindo D, Browne D, Lindo J
Arch Dis Child 2002 Dec;87(6):533. doi: 10.1136/adc.87.6.533. PMID: 12456557Free PMC Article

Prognosis

An investigation into the hammer toe effects on the lower extremity mechanics and plantar fascia tension: A case for a vicious cycle and progressive damage.
Moayedi M, Arshi AR, Salehi M, Akrami M, Javadi Asl N, Naemi R
Comput Biol Med 2023 Jan;152:106381. Epub 2022 Dec 10 doi: 10.1016/j.compbiomed.2022.106381. PMID: 36563541
Using a bone allograft to fixate proximal interphalangeal joint arthrodesis.
Kominsky SJ, Bermudez R, Bannerjee A
Foot Ankle Spec 2013 Apr;6(2):132-6. doi: 10.1177/1938640013480237. PMID: 23511314
Complications and salvage of elective central metatarsal osteotomies.
Derner R, Meyr AJ
Clin Podiatr Med Surg 2009 Jan;26(1):23-35. doi: 10.1016/j.cpm.2008.09.003. PMID: 19121751
Correction of crossover second toe deformity.
Graziano TA
Clin Podiatr Med Surg 1996 Apr;13(2):269-78. PMID: 9118018
Surgery for curly toe deformity: a double-blind, randomised, prospective trial.
Hamer AJ, Stanley D, Smith TW
J Bone Joint Surg Br 1993 Jul;75(4):662-3. doi: 10.1302/0301-620X.75B4.8331129. PMID: 8331129

Clinical prediction guides

Conservative Approach in the Management of Lesser Toe Deformities in Older Adults.
Formosa C, Grixti C, Gatt A
J Am Podiatr Med Assoc 2022 May-Jun;112(3) doi: 10.7547/20-274. PMID: 36074350
Assessment of the severity of curly toe.
Satake H, Kura H, Naganuma Y, Honma R, Shibuya J, Nito T, Suzuki A, Takakubo Y, Ishigaki D, Takagi M
J Orthop Sci 2022 Nov;27(6):1278-1282. Epub 2021 Sep 6 doi: 10.1016/j.jos.2021.08.001. PMID: 34503899
Claw Toe: Anatomic Guide for Injection of Botulinum Toxin into Foot Muscles.
Takekawa T, Takagi S, Kitajima T, Sato T, Kinoshita K, Abo M
Can J Neurol Sci 2022 Jan;49(1):102-108. Epub 2021 Mar 26 doi: 10.1017/cjn.2021.52. PMID: 33766160
Percutaneous flexor digitorum brevis tenotomy: An anatomical study.
Carvalho P, Dalmau-Pastor M, Lozi C, Souza M, Lucas-Y-Hernandez J, Laffenêtre O
Foot Ankle Surg 2022 Feb;28(2):176-180. Epub 2021 Mar 2 doi: 10.1016/j.fas.2021.02.011. PMID: 33678524
Differences in toe flexor strength and foot morphology between wheelchair dependent and ambulant older people in long-term care: a cross-sectional study.
Yokozuka M, Sato S
J Foot Ankle Res 2021 Mar 12;14(1):17. doi: 10.1186/s13047-021-00458-8. PMID: 33712068Free PMC Article

Recent systematic reviews

A systematic review of the claw toe deformity: What is known and what is needed apart from surgical procedures.
de Jesús Mayagoitia-Vázquez J, López-López D, Miguel-Andrés I, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias M, Gómez-Salgado J, Ortiz-Lango LÁ
Int Wound J 2024 Oct;21(10):e70073. doi: 10.1111/iwj.70073. PMID: 39379064Free PMC Article
Guidelines on offloading foot ulcers in persons with diabetes (IWGDF 2023 update).
Bus SA, Armstrong DG, Crews RT, Gooday C, Jarl G, Kirketerp-Moller K, Viswanathan V, Lazzarini PA
Diabetes Metab Res Rev 2024 Mar;40(3):e3647. Epub 2023 May 25 doi: 10.1002/dmrr.3647. PMID: 37226568
Ideal implant choice for proximal interphalangeal joint arthrodesis in hammer toe/claw toe deformity correction: A systematic review.
Wei RX, Ling SK, Lui TH, Yung PS
J Orthop Surg (Hong Kong) 2020 Jan-Apr;28(1):2309499020911168. doi: 10.1177/2309499020911168. PMID: 32223520
Flexor Tenotomy Improves Healing and Prevention of Diabetes-Related Toe Ulcers: A Systematic Review.
Bonanno DR, Gillies EJ
J Foot Ankle Surg 2017 May-Jun;56(3):600-604. doi: 10.1053/j.jfas.2017.02.011. PMID: 28476394
Effectiveness of percutaneous flexor tenotomies for the management and prevention of recurrence of diabetic toe ulcers: a systematic review.
Scott JE, Hendry GJ, Locke J
J Foot Ankle Res 2016;9:25. Epub 2016 Jul 29 doi: 10.1186/s13047-016-0159-0. PMID: 27478505Free PMC Article

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