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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

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
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
Lesser toe deformity classification: A simplified approach with treatment influence.
Weyandt Z, Capuzzi M, McGlone W, Bernatsky A, Ford T
Foot (Edinb) 2021 Sep;48:101819. Epub 2021 May 4 doi: 10.1016/j.foot.2021.101819. PMID: 34332395
Fibrodysplasia ossificans progressiva: Review and research activities in Japan.
Haga N, Nakashima Y, Kitoh H, Kamizono J, Katagiri T, Saijo H, Tsukamoto S, Shinoda Y, Sawada R, Nakahara Y
Pediatr Int 2020 Jan;62(1):3-13. doi: 10.1111/ped.14065. PMID: 31774601
Modified double plantar plate tenodesis.
Lui TH, LiYeung LL
Foot Ankle Surg 2017 Mar;23(1):62-67. Epub 2016 May 10 doi: 10.1016/j.fas.2016.05.313. PMID: 28159046

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
Imaging of the post-operative hallux valgus: what do radiologists need to know?
Salet E, Legghe B, Barouk P, Stigliz Y, Dallaudiere B, Lintingre PF, Pesquer L
Skeletal Radiol 2023 Sep;52(9):1629-1637. Epub 2023 Mar 22 doi: 10.1007/s00256-023-04322-7. PMID: 36949167
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
Fibrodysplasia ossificans progressiva: Review and research activities in Japan.
Haga N, Nakashima Y, Kitoh H, Kamizono J, Katagiri T, Saijo H, Tsukamoto S, Shinoda Y, Sawada R, Nakahara Y
Pediatr Int 2020 Jan;62(1):3-13. doi: 10.1111/ped.14065. PMID: 31774601
Plantar Plate Injury and Angular Toe Deformity.
Akoh CC, Phisitkul P
Foot Ankle Clin 2018 Dec;23(4):703-713. Epub 2018 Sep 25 doi: 10.1016/j.fcl.2018.07.010. PMID: 30414662

Therapy

Advances in the Causes and Treatment of Floating Toes after the Weil Osteotomy: A Scoping Review.
Guo Z, Xiong B, Zhang L, Cao X, Sun X, Sun W
Orthop Surg 2024 Jun;16(6):1257-1268. Epub 2024 May 1 doi: 10.1111/os.14061. PMID: 38693601Free PMC Article
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 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
Fibrodysplasia ossificans progressiva: lessons learned from a rare disease.
Akyuz G, Gencer-Atalay K, Ata P
Curr Opin Pediatr 2019 Dec;31(6):716-722. doi: 10.1097/MOP.0000000000000802. PMID: 31693578
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

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
Incidence of thyroid disease in patients with forefoot deformity.
Tran SK, Carr JB, Hall MJ, Park JS, Cooper MT
Foot Ankle Surg 2020 Jun;26(4):445-448. Epub 2019 May 30 doi: 10.1016/j.fas.2019.05.014. PMID: 31186135
Hammertoe Correction With K-Wire Fixation Compared With Percutaneous Correction.
Yassin M, Garti A, Heller E, Robinson D
Foot Ankle Spec 2017 Oct;10(5):421-427. Epub 2016 Dec 4 doi: 10.1177/1938640016681069. PMID: 27909213
Operative Treatment for Fourth Curly Toe Deformity in Adults.
Choi JY, Park HJ, Suh JS
Foot Ankle Int 2015 Sep;36(9):1089-94. Epub 2015 Apr 9 doi: 10.1177/1071100715579758. PMID: 25857938
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

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
Minimally invasive correction for symptomatic, fixed curly toe deformity.
Lee DJ, Choi JY, Kim HS, Suh JS
Foot Ankle Surg 2021 Jan;27(1):60-65. Epub 2020 Feb 12 doi: 10.1016/j.fas.2020.02.005. PMID: 32173282

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
Incorrectly fitted footwear, foot pain and foot disorders: a systematic search and narrative review of the literature.
Buldt AK, Menz HB
J Foot Ankle Res 2018;11:43. Epub 2018 Jul 28 doi: 10.1186/s13047-018-0284-z. PMID: 30065787Free PMC Article
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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