Toe pain can slow anyone down, which is why we are here to help! Our surgeons are trained in a variety of conservative and surgical treatment options for toe pain treatment. Schedule an appointment with us, and we can review all of your options.

Toe Evaluation

Hammer toe: sagital plane deformity that involves dorsiflexion at the MTPJ, plantarflexion at the PIPJ, and dorsiflexion at the DIPJ

Claw toe: sagittal plane deformity that involves dorsilfexion of the MTPJJ and planartflexion of the PIPJ, as well as plantarflexion at the DIPJ

Static vs. Dynamic

Flexible vs. Rigid

Congenital vs. Acquired

Causes of Toe Deformities

Flexor Stabilization of the Toe

Most common cause of digital deformities

FDL gains mechanical advantage over the interossei

Clinically, excessive gripping of toes in stance

Often see adductovarus 4^th and 5^th digits

Flexor Substitution of the Toe

Least common cause of digital deformity

Present when the triceps surae is weak

Can be seen after excessive TAL

Extensor Substitution of the Toe

EDL gains mechanical control over lumbricales

Seen in Pes Cavus or Neuromuscular diseases

Extensors fire longer and more intensely

No varus rotation

Toes always clawed

Non-mechanical change of the Toe

Usually appear in isolation 

Typically static in nature

Often 2/2 to long toe with retrograde shoe pressure

Toe Surgery Selection for Hammertoes

Toe Arthroplasty: removing pieces of bone to allow for proper range of motion

Toe Arthrodesis: fusing the painful joint to prevent recurrence and provide a more stable lever arm

Toe Tenotomy: releasing the tendons or capsule that are causing the deformity

Toe Tendon Transfer: releasing and moving tendons to change the pull on the toe joints

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Source: 

McGlamry's comprehensive textbook of foot and ankle surgery, E Dalton McGlamry; Joe T Southerland. Philadelphia : Wolters Kluwer/Lippincott Williams & Wilkins Health, ©2012