- Fixed flexion deformity of the lesser toes (claw toes are not fixed, and can be passively straightened)
- Muscle imbalance in the foot causes the lesser toes of the foot become bent at the first interphalangeal joint.
- It can result in bursitis, or hyperkeratosis over the joints or at the tip of the toe.
- Commonly associated with poor biomechanics and hallux valgus.
- Trauma (direct injury or overuse from walking or sport) is a predisposing factor.
- Diabetes, rheumatoid arthritis, and neuromuscular conditions are risk factors. (motor neuropathy)
- Common in women who wear tighter, narrower shoes with increased heel height.
- Prominent fixed toe deformity, often with arthritis.
- Corn / Callous.
- Difficulty in shoes with deformity of the shoe upper.
- Difficulty in walking.
Tests and Imaging
- Clinical examination and detailed history.
- X-rays often not required but can help to evaluate the extent of deformity and degree of arthritis within the joint.
- Advise appropriate footwear.
- Analgesia for arthritic pain.
- Podiatry for footwear advice/modification, splinting, protection, management of hyperkeratosis.
- Orthopaedic foot surgeon for possible tendon transfer, digital arthroplasty, digital arthrodesis.