Claw and hammer toes

Claw and hammer toes involve a defective positioning of the toes caused by the contraction of the foot’s extensor and flexor muscles. This often leads to pressure strain in the dorsal region of the toe joints, calluses and lesions etc.

In claw toes, the tips of the toes often do not reach down to the ground and the basal toe joint can be luxated, i.e. the toe comes loose from the base joint.

Hammer toes account for the most common toes deformations. They involve a hyperextension in the metatarsophalangeal joint (MTP), and in the distal interphalangeal joint (DIP) and hyperflexion in the proximal interphalangeal joint (PIP). In contrast to hammer toes, claw toes are characterised by hyperflexion in the DIP.

Treatment
Conservative therapy
There is an indication for this if the toe can be straightened passively. In the early stages, an attempt is made to alleviate the symptoms and to prevent progression using physiotherapy and podology.

Orthopaedic technology offers the best options: inserts with retrocapital support, broadened toe cap, straightening splints and bandages as well as orthoses.

Operative therapy
If the defective positioning is flexible and can be corrected, tendon transpositions or a Weil osteotomy can be performed. Hohmann osteotomy or resection arthroplasty are the techniques of choice in the case of contractures.