Toes
Toe deformities are a very common problem in podiatric practice. Our toes are important for walking and stability.
There are various factors which contribute to the deformation of a toe, namely ill-fitting footwear, hereditary factors, flatfeet, muscle imbalance, traumatic injury or disease of the toe joints.
Toe problems include hammer toes, claw toes and bunions.
The extensor and flexor tendons cause the toes to move up and down respectively. They also pull together to provide straight toes. Once one of these tendons becomes more taught than the other, an imbalance occurs, which flexes the toe permanently.
Since a flat (pronated) foot is longer than an arched foot, the flexor tendons become tighter and overpower the other muscles.
In claw toes, these appear like a clenched fist.
In hammer toes, the toe bend is in the ‘proximal’ (or first) bone of the toe, which causes it to rise up.
If the toes are flexible, they can be straightened easily. In this case, mouldable silicone is used to provide a splint. If the condition is caused by flat feet, a podiatrist can fit the patient for custom-molded orthoses that provide better arch support and help the muscles work together. Without treatment, these deformities become more rigid and surgery would then be indicated.
Bunions are another common type of toe deformities. In this condition, the big toe is angled excessively towards the second toe. A bony deformity on the side of the big toe makes wearing of shoes a problem. This prominence is prone to inflammations and bursitis, a fluid-filled sac that becomes inflamed due to rubbing against the shoe. The second toe may then become overlapping, resulting in painful rubbing against the top of the shoe.
Orthoses may be used to correct the way a person walks and so reduce pressure on the big toe. Custom made silicone toe separators may help prevent the formation of corns between the toes. In severe cases, surgery may be indicated.
Regular checkups, especially if your family has a history of such problems, should be done. Remember that children grow in spurts and they should never wear small-fitting shoes.
The best way to prevent toe deformities and associated problems is to discuss these with a podiatrist.
Podiatrist Alfred Gatt.