Claw Toe Deformity

A claw toe is a relatively common toe deformity affecting one or more of the lesser toes, causing them to curl round and adopt a claw-like shape. The condition can become so severe that the toe can curl around and under the foot making balance and walking difficult. The change in the gait which results from the deformity can have an effect on other areas of the feet, and can make other foot conditions more likely to occur.

Once a claw toe starts to develop it is critical that it is treated as early as possible as it is unlikely to correct itself without medical intervention or a change made to remove the cause of the problem. The earlier this condition is addressed, the easier it is to straighten claw toes without needing to resort to surgery.

Claw toes result from the contraction of the flexor digitorum brevis tendon, which pulls the middle bones of the toes upwards. Tendons and ligaments which have tightened can cause the toes to curl downward, resulting in claw toes forming.
There are two types of claw toes with the distinction based on the mobility of the toe joints, although they are essentially the same condition in varying stages of development. There is a flexible claw toe and a rigid claw toe. Flexible claw toes still have the ability to move, and thus have higher chance of being able to be straightened by conservative treatments. A rigid claw toe on the other hand may not be moved at all, or movement may be highly limited. Movement of the toe in both cases can be painful, and walking can be problematic.
Many factors can potentially cause claw toes but the most common are foot muscle imbalances which cause the tendons and ligaments to become tight. Accidents resulting in damage to the feet, together with neuromuscular problems have also been linked to claw toe formation, with osteoarthritis, rheumatoid arthritis, strokes and diabetes all having a strong link with the toe deformity. Having flat feet, fallen arches and other foot structure abnormalities can also contribute to the development of claw toes.
People suffering from this condition have toes which bend upward at the first interphalangeal joint in the toe, and also at the second, or distal interphalangeal joint. The claw toe can be viewed as a hammer toe and mallet toe forming on the same toe. Sometimes the toe will bend downward to the sole, and may even curl underneath the foot. Usually the problem is accompanied by corns on top of the toes from the pressure and friction from wearing shoes, and callused can form on the bottom of the foot due to changes in pressure and weight distribution.
To diagnose claw toes, your doctor may only need a physical examination as this deformity is very evident. During the exam, your doctor may measure your foot’s flexibility and stability and he may also check for redness and swelling around your toes. In rare cases, you may be advised to have a foot X-ray to spot any existing bone defects and to determine the extent of the problem. A doctor may also arrange for other tests to be completed to check for any underlying conditions which could have contributed to the formation of a claw toe, such as diabetes.
If claw toes are detected early they can be treated using foot orthotics, stretching exercises and a change of footwear to allow for the correct orientation of the toes. For rigid claw toes surgery may be required to cut the tendon or make adjustments to the bones to allow normal extension.