Posted on March 27, 2008 in Latest News
A mallet toe occurs when the joint at the end of the toe cannot straighten. In the pediatric population it is often flexible and not painful. Over time the deformity becomes rigid and a callous may form on the skin overlying the joint at the end of the toe. Additionally the toenail may become thickened and deformed form the repetitive jamming of the toe while walking.
Excessive rubbing of the mallet toe against the top of the shoe can lead to pain and the development of a corn. The tip of the toe is often turned down against the shoe causing pressure and discomfort. The deformity usually involves one or two toes, with the second toe most commonly affected. Mallet toes have several aetiologies.
Arthritis can also lead to many forefoot deformities including mallet toes. Mallet toes can cause extreme discomfort, and can be aggravated if restrictive or improperly fitting footwear is worn for a prolonged period of time.
Diabetic patients often develop ulcerations on the ends of their toes secondary to mallet toe deformity and the pressure that results from the toe jamming into the shoe. When standing, the toe will demonstrate a contracture, with the tip of the toe facing downward into the floor. If the deformity is flexible a simple release of the tendon in the bottom of the toe will allow straightening of the toe.
Treatment
Conservative treatment of mallet toes begins with accommodating the deformity. The goal is to relieve pressure, reduce friction, and transfer forces from the sensitive areas.
However, the only effective way of correcting the deformity is to have an operation. A digital arthroplasty is usually sufficient to straighten the toe. This involves removing half of the joint to allow it to become free and therefore corrected. In some instances, if the bone in the middle of the toe is very small, it is easier to remove the whole bone.
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