Synonyms
Claw toes, claw toes
Introduction
Claw toes are malpositioned toes, which often occur together with a hallux valgus and a splayfoot. They are characterized by hyperextension of the metacarpophalangeal joint in flexed middle and distal toe joints. There are many causes for the formation of claw toes.
Basically, a distinction is made between congenital causes, such as foot malpositioning in the sense of a splayfoot, flat foot and pigeon-toed foot, as well as neurological and accident-related foot diseases. In addition, civil historical influences, such as shoes that are too tight and walking barefoot too little, play a decisive role. In the course of life, there is a gradual curvature of the toes and painful pressure points all over the foot with the development of corns (clavus). Consistent conservative measures such as toe gymnastics, padding, insole care and the wearing of open wide shoes cannot always stop the deterioration, even in the early stages of the disease, so that in the further course of the disease an operation is sometimes necessary. Nevertheless, foot gymnastics should be done independently at an early stage.
Frequency
Claw-toes are frequent occurring toe malformations. They usually occur in combination with other foot deformities such as hallux valgus or splayfoot. In the early stages, the toes can often be passively returned to their normal position, but in the further course of the disease, a stiffening of the toes II – V in their joint parts, which cannot be compensated either passively or actively, occurs. All in all, claw toes occur less frequently than hammer toes.
Causes
In addition to a genetic-inherited component, toe deformities are caused, among other things, by wearing unsuitable shoes, often with a heel that is too high. In shoes that are too tight, the toes bump and bend at the front and the pressure on the so-called forefoot increases. Especially the short toe extensors have the function of keeping the toes in their stretched position.
However, due to lack of movement and constant support of the foot muscles by the footwear, the foot muscles atrophy. In the course of the disease, the flexor muscles become more tense, which increases the curvature of the toes. These also shorten over time, causing the toes to become even more crooked. Some other reasons for the formation of a claw toe include the following:
- Neurlogical disorders, especially in the hollow foot and spastic paralysis
- Inflammatory diseases of the foot caused by muscle and nerve injuries of the lower leg and foot, chronic polyarthritis
- Scar tension, due to hardening of the scar tissue
- Sudeck’s dystrophy (tissue change after an accident)
- In rare cases claw toes can be congenital
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