Lesser toe problems

 

There are three main forms of toe abnormalities:

• Claw toes(dorsal subluxation of the MTPJ with flexion deformity of the PIP and DIPJs)
• Hammer toes(extension of the MTP joints and DIP joints. PIP joints hyperflexed)
• Mallet toes(flexed DIP joint, most commonly 2^nd toe)    

 

 

 

Conservative Management:

 

Refer to surgeons if:

Conservative measures have been tried for 12 weeks including specialist footwear, orthoses,  analgesia (+/-podiatry referral), splinting, steroid injections AND

• The patient has persistent pain or deformity causing significant functional impairment* OR
• There is threatened skin ulceration OR
• Moderate to severe deformity that prevents patients from finding comfortable footwear

 

AND the patient is willing to consider surgery 

 

*Significant functional impairment is defined as a restriction or interference with an individual’s capacity to meet personal, social or occupational demands.  Please state the impairment of the individual is experiencing.

Imaging - Please include an up to date X ray with weight bearing views report within or attached to the referral.  This includes for soft tissue injuries to exclude underlying pathology.  .

Referrals without up to date reports included and Xrays that are not weight bearing will be returned, unless there are mitigating circumstances why this is not possible

REFERENCES:

British Orthopaedic Association: Commissioning Guides – Painful deformed great toe in adults

https://patient.info/doctor/toe-deformities

 

Date reviewed                     8/2/2022

Next review due                  8/2/2023

Sifter name                          Dr Rebecca Hopkins

 

Version No. 1.2