Hallux malleus is a deformity of the great toe. This deformity can be very stiff or flexible. The joint in the great toe  becomes contracted in a flexed or downward position. This deformity usually occurs due to an imbalance of the tendons that insert on the top and the bottom of the great toe. When the tendon on the bottom of the toe (the tendon that causes the toe to flex down) over powers the tendon that causes the toe to bend up, this deformity occurs.

Oftentimes, patients will develop a callus and even an ulcer on the tip of the great toe. This deformity is often seen in conjunction with hammertoes. High arched feet are typically the most affected by this deformity.

At Advanced Foot & Ankle Center, this deformity is treat initially with padding techniques to prevent sores from developing at the tip of the toe.  Custom, soft, accommodative orthoses are sometimes prescribed for the patient to provide cushioning and also to prevent worsening of the deformity.

If conservative treatment fails, surgery is indicated. Surgery usually consists of performing a bone fusion of the 2 bones in the great toe. This can be done with screws, staples, or wire fixation.

If you have a hallux malleus deformity, please come see Dr. Kory Williams or Dr. Eric Silvers at Advanced Foot and Ankle Center in McKinney, TX and Prosper, TX.

Call today to set up an appointment with the podiatrists – 972-542-2155.

A claw toe is a toe that is contracted at the PIP and DIP joints (middle and end joints in the toe), and can lead to severe pressure and pain. Ligaments and tendons that have tightened cause the toe’s joints to curl downwards. Claw toes may occur in any toe, except the big toe. There is often discomfort at the top part of the toe that is rubbing against the shoe and at the end of the toe that is pressed against the bottom of the shoe.

Claw toes are classified based on the mobility of the toe joints. There are two types – flexible and rigid. In a flexible claw toe, the joint has the ability to move. This type of claw toe can be straightened manually.

A rigid claw toe does not have that same ability to move. Movement is very limited and can be extremely painful. This sometimes causes foot movement to become restricted leading to extra stress at the ball-of-the-foot, and possibly causing pain and the development of corns and calluses.

Cause

Claw toes result from a muscle imbalance which causes the ligaments and tendons to become unnaturally tight. This results in the joints curling downwards. Arthritis can also lead to many different forefoot deformities, including claw toes.

Treatment and Prevention

Changing the type of footwear worn is a very important step in the treatment of claw toes. When choosing a shoe, make sure the toe box (toe area) is high and broad, and can accommodate the claw toes. A shoe with a high, broad toe box will provide enough room in the forefoot area so that there is less friction against the toes.

Other conservative treatments include using forefoot products designed to relieve claw toes, such as toe crests and hammer toe splints. These devices will help hold down the claw toe and provide relief to the forefoot. Gel toe shields and gel toe caps are also recommended to eliminate friction between the shoe and the toe, while providing comfort and lubrication.

Hammertoe Crest Pad

Gel Toe Cap

Budin splint / Toe Straightener

If you feel you may have clawtoes, please come see Dr. Williams or Dr. Silvers for treatment.

The address to our facility is as follows:

McKinney Office Location

4501 Medical Center Drive: Suite 300

McKinney,  TX 75069

To schedule an apppointment, please call : 972-542-2155

Prosper Office Location

140 N. Preston Road: Suite 30

Prosper, TX 75078

To schedule an appointment, please call:  972-542-2155

Enjoy! Have a great day!

P.S. – These are not recommended to wear.

~Dr. Williams

The shortening of the bone is caused by the growth plate pre-maturely closing before growing out to full length. The cause why this happens is still mostly unknown.

Brachymetatarsia is related to following disorders and syndromes:

• Down’s Syndrome
• Turner’s syndrome
• Pseudohypoparathyroidism
• Psuedo-pseudohypoparathyroidism
• Albright’s syndrome
• Diastrophic dwarfism

Bracymetatarsia usually occurs in females and usually occurs in both feet. X-rays usually confirm the shortening of the metatarsal.

As a child, the deformity is usually asymptomatic. The primary complaint in the younger patient is often cosmetic, and many times these patients are self-conscious about their appearance. Older patients may experience symptoms of pain due to excessive pressure under adjacent metatarsal heads. Increased callus formation in the ball of the foot may be present. Skin, soft tissue, and tendon contractions lead to additional discomfort with the use of shoes.

Treatment of brachymetatarsia may include conservative care, such as an orthotic device to take pressure off the adjacent metatarsal heads. Shoe gear may be modified a possible hammertoe deformity or contracture of a toe.

Definitive treatment requires surgical correction to address the soft tissue contractions as well as the shortened metatarsal. Numerous surgical procedures exist to correct brachymetatarsia such as the following:

• Bone Grafts
• Metatarsal osteotomies
• Distraction of the metatarsal with an external fixator
• Tendon lengthening
• Skin modifications

At Advanced Foot & Ankle, Dr. Williams prefers the procedure in which lengthening of the metatarsal is performed with an external fixator. Below is a picture showing the external fixator on the 4th metatarsal bone allowing distraction of the bone.

Please come see Dr. Williams or Dr. Silvers if you have brachymetatarsia and we can discuss your treatment options.

The address to our facility is as follows:

McKinney Office Location

4501 Medical Center Drive: Suite 300

McKinney,  TX 75069

To schedule an apppointment, please call : 972-542-2155

Prosper Office Location

140 N. Preston Road: Suite 30

Prosper, TX 75078

To schedule an appointment, please call:  972-542-2155

Hammertoes

An inherited muscle imbalance or abnormal bone length can make one or more small toes buckle under, causing their joints to contract. This in turn causes the tendons to shorten. Corns (build-ups of dead skin cells where shoes press and rub) often form ojn top of the contracted joints, and may become irritated and infected. Hammertoes are surgically corrected by various means depending on the flexibility or rigidity of the deformaty. Sometimes the hammer toe is repaired by a procedure known as an Arthroplasty where a portion of the contracted joint is removed. Other times the deformity is repaired by a procedure known as an Arthrodesis where the contracted joint is repaired by fusing the joint together.

Often, a foot with a bunion will also have a hammertoe. Overtime, the bunion slants the big toe toward and then under the second toe (the most often “hammered” toe), raising the second toe to a claw-like position.

Hammertoes can also occur when a bunion is not present. Those people with high arches, a tendency to rotate theri feet inward when walking, or rheumatoid arthritis, are especially susceptible. Once stiffened into position, hammertoes rub against shoes and cause painful corns and calluses.