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CONDITION/DISORDER SYNONYM
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M20.40 Other hammer toe(s) (acquired), unspecified foot
Q66.89 Other specified congenital deformities of the feet
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PREFERRED PRACTICE PATTERN
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4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion (ROM) Associated with Localized Inflammation1
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PATIENT PRESENTATION
A 26-year-old female states she was walking at night in her apartment barefoot to go to the kitchen when she kicked the leg of the sofa which she did not see. Patient states she had severe pain and ecchymosis. She had X-rays which were negative on her second toe. She presents with flexion at the distal interphalangeal (DIP) joint with pain during ambulation. The distal joint of the second toe is bent into a claw like position.
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Distal joint of the toe is bent into a claw like position
Usually due to trauma from impact on tip of the toe
Flexor muscles, fascia, tendons shorten
Flexion of the DIP joint
Most commonly affects the second toe as it is the longest; can also be third to fifth
May alter mechanics during the push-off phase of gait
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Essentials of Diagnosis
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Diagnosis is usually made by clinical examination or X-ray
Can be an independent diagnosis and not associated with a disease process
Can be flexible in the developmental stage
Rigid toes will have tight tendons and joint capsules
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General Considerations
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Infants
Children
Adults
Dancers
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SIGNS AND SYMPTOMS
Pain in metatarsal with walking
Corn on top of the toe above the DIP joint
Decreased extension or dorsiflexion of the toe
Joint redness and pain
Callus formation under the metatarsal head
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Functional Implications
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