Dr. Kevin Stonestreet

Kevin Stonestreet, DPM is the newest member of FAWCPA.

Doctor Resources

Anatomy Of Your Toes

Your toes and feet take you places. You use them to stand, walk, run, and dance.

Foot anatomy is complicated, and more than half of the bones in the human body are in your feet. Feet have three main sections – the forefoot, midfoot, and hindfoot. Your toes are in the forefoot.

In the forefoot are five toes, or phalanges, and five longer bones, or metatarsals, that connect the toes to the midfoot.

Each phalange consists of three phalanx bones – the proximal, middle, and distal – with the exception of the big toe, which has only has proximal and distal bones.

The joint between the metatarsals and phalanges is called the Metatarsophalangeal Joint, or MTP joint. These MTP joints form the ball of the foot and help your toes flex and extend. The joint between the proximal and middle phalanx is known as the Proximal Interphalangeal Joint, or PIP joint. The PIP joint helps toes curl and grip.

All toes except the big toe are know as lesser toes. Lesser toes and their joints flex and contract by the action of muscles, tendons, and ligaments on the top and bottom of your feet.

When forces such as tight shoes or high heels bend your toes, conditions such as hammertoe and claw toe can occur over time. Your toes are forced to work harder in less space, and the resulting muscle and tendon imbalance causes muscles to shorten and toes to curl, and may worsen the condition.

All information provided on this website is for information purposes only. Every patient’s case is unique and each patient should follow his or her doctor’s specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2016 Smith & Nephew, All Rights Reserved.

Hammertoe

Hammertoe is a condition caused by the joints of the metatarsal and phalanges contracting and bending the toe into an arched position that resembles a hammer. A common cause of hammertoe is a tight toe box in shoes, typically found with high heels that may be too small. The size, angle, and structure of the shoes force the toes into a compromised position, causing poor circulation, restricted movement, plus aggravation to the bones and ligaments in the foot and toes. Trauma is also a cause of hammertoes, and heredity may play a factor.

Early stages of hammertoe are mild, and the compromised joints are still flexible. At this stage, non-surgical treatment and appropriate footwear can help. Without treatment, however, the condition will worsen and joints will become stiff and inflexible. At that point, surgery is the only option.

Symptoms

Earliest stages are unsightly and uncomfortable but may not yet resemble the curved appearance of later stages. The appearance of hammertoe and its distinct shape is an indicator.

Symptoms of hammertoe include:

  • Wearing shoes causes pain and irritation on toes.
  • Corns and calluses appear between two toes, the ball of the foot, or on an affected toe that rubs against the shoe.
  • Long-term friction also can cause open sores on toes.
  • Burning sensation and a red, and inflammed appearance.
  • Curved appearance that progresses if left untreated.
  • Stiff, inflexible joints.

Diagnosis and Treatment

Early stages of hammertoe may appear as simple foot problems, but the curved appearance indicates a condition that must be treated or it will worsen.

A foot and ankle surgeon or podiatrist will review your symptoms and thoroughly examine your toes and foot. Manipulation of foot and toes and degree of toe contraction will show whether the toe joint is flexible or rigid. X-rays may be required to diagnose how severe the toe or toes are deformed.

Early stage hammertoe may be treated non-surgically with better-fitting shoes, therapy, splint, tapes, and orthotics. If surgery is required, your surgeon may recommend one or more procedures to restore toes to their proper alignment and functionality. To learn more about surgical options, please review the HAT-TRICK◊ section of this website.

All information provided on this website is for information purposes only. Every patient’s case is unique and each patient should follow his or her doctor’s specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2016 Smith & Nephew, All Rights Reserved.

Clawtoe

Claw toe is similar in appearance to hammertoe, but the distal joint of the foot is also bent, giving your toes a claw-like appearance. Tight, improperly fitted shoes may be a factor of claw toe, but nerve damage, diabetes, alcoholism, and other vascular and muscle damaging conditions also can cause the muscle constriction. Failure to treat claw toe may result in permanent toe malformation that requires surgical intervention.

Symptoms

Claw toe may begin as a slight curve affecting multiple joints of the toe. It advances to the curved, claw-like appearance in which your toes bend upward from the metatarsal bones at the ball of your foot and downward from the middle joints. Unlike hammertoe, with claw toe the distal joint continues to bend and curls the distal phalange under the foot. That two-part curve is a clear sign of later stages.

Additionally, the tops of toes or ball of the foot may develop corns and calluses.

Claw toe may also indicate, or be caused by, neurological disorders that weaken foot and toe muscles, resulting in imbalance and bending. Curvature after trauma may also indicate the beginnings of claw toe.

Treatment

Like hammertoe, the joints affected are flexible at first, but can become rigid over time. Non-surgical treatments such as better-fitting shoes, therapy, splints, and orthotics can help relieve symptoms. Additional treatment is necessary for other neurological conditions that cause claw toe. If surgery is required, your surgeon may recommend one or more procedures to restore toes to their appropriate alignment and movement. To learn more about surgical options, please review the HAT-TRICK◊ section of this website.

All information provided on this website is for information purposes only. Every patient’s case is unique and each patient should follow his or her doctor’s specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2016 Smith & Nephew, All Rights Reserved.

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