Claw Toes

Question 1

What joints are affected in claw toe

Answer 1

Flexion deformity at the PIP and DIP joints Hyperextension at the MTP joint

Question 2

How do you complete the examination of claw toes

Answer 2

Watch the patient walk Examine her shoes Ask her about the effect on her life

Question 3

What is the cause of claw toes

Answer 3

Imbalance between intrinsic and extrinsic muscles of the lesser toes Maybe secondary to neurological disorders:- Peripheral neuropathy Lower motor neurone disease (eg. Poliomyelitis) Upper motor neurone disease (eg. Cerebral palsy, MS, stroke)

Question 4

Who gets claw toes

Answer 4

Females more than males Elderly Patients with RA

Question 5

How do you treat claw toes

Answer 5

Non-surgical:- Appropriate footwear Surgical for mobile deformity:- Flexor-to-extensor tendon transfer Surgical for fixed deformity:- Resection of the proximal phalangeal head and neck, with possible flexor and extensor release Extensor tenotomy for contractures of the MTPJ Resection of the metatarsal heads of the lesser toes

Question 6

Which toes are commonly affected by claw toes

Answer 6

The lesser toes - frequently all four are involved May be bilateral

Question 7

What is this?

Answer 7

Claw toes

Question 8

What is appropriate footwear for claw toes

Answer 8

High

Wide toeboxes

Semirigid longitudinal arch supports with metatarsal pads to evenly distribute plantar pressure