Claw toes are a foot deformity caused by an imbalance in toe tendons, often due to flat feet. Treatment includes medication, therapy, and surgery. Claw toes are more common in older women and can be caused by neuromuscular or inflammatory diseases.
Claw toes are a type of foot deformity that is so called because the toes resemble an animal’s claws. The characteristic shape of claw fingers is a curve, with the fingers curving sharply upward and then downward in a C shape. Claw finger deformities are caused by an imbalance in the way the tendons of the toes twitch. The underlying cause of this imbalance is often flat feet.
The movement of each toe is controlled by six different muscle sets, as well as different tendons. The muscles serve to stabilize the toes and combine with the tendons to regulate movement. When the foot is unbalanced in any way, such as occurs in flat feet, this can cause the larger muscles in the toes to exceed the ability of the smaller muscles to perform properly.
A number of structural foot deformities can result from this type of muscle imbalance. In the case of claw fingers, the deformity develops when a muscle called the flexor digitorum brevis contracts excessively and overwhelms the smaller finger muscles. The strong contraction causes the middle bone of the toe to pull downward. This action causes another toe joint to bend upward, producing the characteristic C-shaped curve of the claw toe deformity. The most common symptom of the deformity is pain, which can be accompanied by complications such as calluses or abscesses.
One of the most common causes of claw toes is flat feet, which cause the foot to stretch slightly and unbalance the toe muscles. Several neuromuscular diseases, including cerebral palsy and multiple sclerosis, also cause the development of this deformity. In addition, inflammatory diseases such as diabetes, psoriasis, and rheumatoid arthritis can cause claw finger deformities. Claw fingers are more common in older people and are about five times more common in women than in men. The reason for this gender imbalance is unknown.
Treatment of claw toe initially involves medication or therapy to treat the underlying cause of the problems. Anti-inflammatory drugs, antibiotics, or other medications may be indicated depending on the cause of the claw deformity. Wearing loose-fitting or open-toed shoes can help prevent further problems, and padding can be applied to avoid putting pressure on the toes which could cause complications. These treatments may prove effective if the claw toe deformity is new, but if your toes have been clawed for some time, you may need surgery.
Toe claw surgery is the only treatment that can correct the structural defect if the soft tissue in the toes becomes tight and stiff. The surgery involves trimming the joints that are causing the toes to buckle, so that the toes can straighten. This surgery is called arthroplasty. If this surgery is unsuccessful, an additional procedure called arthrodesis may be performed. In this operation, the deformed toe bones are fused together to restore normal foot structure and mobility.
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