Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ 735.5 Claw toe (acquired)755.66 Other anomalies of toes ++ M20.5X9 Other deformities of toe(s) (acquired), unspecified foot ++ 4E: Impaired joint mobility, motor function, muscle performance, and range of motion associated with localized inflammation +++ Description ++ Toe is bent into a claw-like positionFlexor digitorum brevis contraction/shorteningHyperxtension of the MTP joint with Flexion of the proximal interphalangeal joint (PIP)Flexor muscles, fascia, tendons shortenMost commonly affects the second toe; can also affect the third to fifth +++ Essentials of Diagnosis ++ Diagnosis is usually made by clinical examination or x-rayCan be an independent diagnosis and not associated with a disease process +++ General Considerations ++ SwellingInflammation around the jointCan be associated with medical conditionsCan be a flexible or fixed deformity +++ Demographics ++ InfantsCongenitalChildrenWearing footwear that is too smallAdultsPoor footwear: improper fit/toe comes to a point/narrow forefoot/high heelsDancers +++ Signs and Symptoms ++ Pain in metatarsal with walkingCorn on top of the toeAltered joint positionDecreased extension or dorsiflexion of the toeJoint redness and painCallus formation under the metatarsal headDifficulty finding shoes that fit properlyLimited motion of the MTP joint +++ Functional Implications ++ Pain with standingPain with ambulation at the affected toeInability to wear stiff shoesNeed to wear larger shoes to accommodate bunion, large toe boxAlteration of gait pattern and mechanical issues of the forefootAltered mechanics during the push-off phase of gait +++ Possible Contributing Causes ++ Muscle imbalanceTraumaTibia fracturePes planus (flat foot)Improper footwearCommonly seen in conjunction of bunionsJoint arthritis/injuryMuscle atrophyNerve damageSpinal cord injuryFriedrich’s ataxiaOsteoarthritisRheumatoid arthritisStrokeCharcot-Marie-Tooth diseaseDiabetes mellitus +++ Differential Diagnosis ++ Mallet toe: different in that it is flexion of only the DIPHallux valgusGoutOsteochondrotic lesion of the first metatarsal headSesamoiditis, turf toeOsteochondritis dissecansMetatarsalgiaMetatarsal stress fracture +++ Imaging ++ X-ray ++ Bone spur, location and size +++ Surgical ++ To straighten out the toeCut or lengthen tendons and ligamentsFusion of the jointTendon transfer1,2 +++ Medication ++ Anti-inflammatory ++ For imaging, x-rayFor medication, anti-inflammatory or corticosteroid injectionFor surgical consult1 ++ Antalgic gait secondary to pain at the toe with push-offHypomobility of the MTP jointInability to ambulate distances of one mile secondary to pain ++ Rest, weight off feet will allow for reduction of inflammationOrthotics with ray cut outSwellingCryotherapy... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.