What is Lesser Toe Deformity?
Lesser toe deformity is an abnormality in the anatomy of your toe that occurs as a result of imbalance between the intrinsic and extrinsic muscles.
Lesser toes in your foot are those other than the big toes and together stabilise your foot while standing and help in balancing the body. Lesser toes are susceptible to various deformities that can affect their position and cause other complications of the toes.
Anatomy
Anatomically, the foot is divided into the forefoot, mid foot and hind foot. The forefoot has 4 small toes called phalanges and 1 large toe called the hallux or big toe. Phalanges have 3 bones and 3 joints, while the big toe has 2 bones and 2 joints. The mid foot and hind foot have different structures, which are responsible for bearing body weight and performing activities such as walking and running.
Common Types of Lesser Toe Deformities
Some of the most common types of lesser toe deformities include claw toe, hammer toe, and mallet toe. All of these conditions are caused by one of the tendons in the foot contracting, resulting in a deformed structure of the toes:
- Claw toe: In this condition the first bone appears raised and the second two bones point downwards giving a picture of a claw toe.
- Hammer toe: Anatomically, the 3 toe bones should form a straight line, but in a hammer toe condition, the first bone appears slightly raised, the second bone tilts downwards, and the bone at the tip appears almost flat giving a hammer-like feature.
- Mallet toe: In this condition, the first 2 bones are straight but slightly raised and the bone at the tip points downwards giving a mallet-like appearance (a type of hammer).
Causes
The likely causes of lesser toe deformities include:
- Improper or poorly fitting shoes
- Trauma
- Diabetes
- Genetic factors
- Inflammatory arthritis
- Neuromuscular or metabolic disorders
Signs and Symptoms
Some of the common signs and symptoms of lesser toe deformities include:
- Crooked or curly toes
- Pain and discomfort
- Local swelling
- Malalignment of toes
- Functional difficulty
- Bony prominence
What if the Condition is Left Untreated?
If left untreated, the abnormal bending of your toes becomes permanent and rigid over time impacting the normal function of your foot.
Diagnosis
Your surgeon will physically examine the affected foot in a relaxed state and look for swelling, calluses, or redness. The surgeon may also assess:
- Flexibility, stability, or sensation of your toes
- Weight-bearing while walking
Finally, an X-ray of the foot may be taken to confirm the condition.
How is Lesser Toe Deformity Treated?
Many lesser toe deformities may need surgical intervention. However, nonsurgical or conservative treatments with appliances can be tried in cases of early stage deformities. These conservative treatments include:
- Stretching and strengthening exercises for toe muscles
- Wearing roomy or modified shoes
- Use of shoe inserts or digital pads
If the deformity is severe, either of the following surgery is performed to treat the condition.
Soft tissue correction: The trapped soft tissue is released to lengthen the tendons and the toe is brought down.
Joint resection or fusion: A small piece of cartilage from the bent joint is removed and the joint is straightened, and the bones fused together.
Your surgeon will explain to you the details of each procedure and choose the one that is appropriate for your condition.
