Hammer toe, Mallet and Claw toe

1. [noun] hammer, Claw and Mallet Toe are similar conditions, all caused by deformity of 1 or more joints in the toes. Normally, muscles and tendons attach onto the bones of the toes and control the position and function of the toes. If tightness or weakness develops in the tendons or the intrinsic muscles, the joints are pulled into the wrong position resulting in a deformity. Deformities of this type are more prevalent in seniors and five times more likely to be female. Causes: · Poor footwear (narrow toe box, shoes too small) · Muscle imbalance · Nerve damage · Toe length imbalance · Peripheral Vascular disease (poor oxygen supply to nerves resulting in motor nerve damage) · Foot biomechanics (flat feet, bunion) · Neural disease (peripheral or central nervous system disease) · Diabetes – Peripheral neuropathy & Peripheral vascular disease related to diabetes · Joint disease (Rheumatoid arthritis) · History of previous injury (for example fracture) · Genetics Results in: · Pain · Corn / Callus formation · Long term stiffness / rigid toes · Difficulty fitting shoes · Higher pressure areas Treatment: · Foot exercise (stretch muscle/tendons to reduce risk of digit stiffening or becoming rigid) · Orthotics (relieve pressure points) · Appropriate footwear · Splints or straps (correct muscle imbalances and lengthen tendons) *assessment for appropriate use – client specific. For example, may not be appropriate for use with seniors with limited mobility. · Steroid injection (comfort and inflammation management) · Surgery - The type of surgery required will depend on how limited the joint movement is. Surgery may be done on the tendons to length them or small fragments of bone may need to be removed to allow for realignment

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