Foot care is an essential part of a health regimen. Even a small cut or a blister can lead to serious consequences. While daily wear and tear of feet, standing for long hours, and tight or high-heeled footwear may cause occasional toe pain, persistent ache sometimes leads to an abnormal flexion deformity called mallet toes. An upward bend at the toe joint, this problem forces the toe to curl instead of letting it stay flat. More often developing at the distal interphalangeal joint that is aligned in a neutral position of feet without extension, the most affected toe is the longest one. The disease develops when the push is repeatedly upward.
The cause of the mallet toes is associated with trauma, arthritis, neuromuscular and metabolic diseases. It can also occur because of hereditary reasons. Mallet toes involve two parts of the body called the distal interphalangeal joint and the flexor digitorum longus. The FDL muscle that runs down to smaller toes curls up the toe. The ailment usually occurs in flexible or rigid forms. The muscle and toe joints are movable in the case of flexible mallet toes, but the muscle begins to tighten in the case of rigid mallet toes. This anomaly freezes the toe joint in a bent uncomfortable position.
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Difference Between Mallet Toes, Hammertoes, And Claw Toes
While these three conditions primarily affect joints in the toes and are confused with each other, they have the following stark differences:
Mallet Toes: The bend is in the third toe joint, the one closest to the toenail.
Claw Toes: The bend is in the first and sometimes in the second and third joint giving it a claw like appearance and making it inflexible
Hammer Toes: The bend is in the middle toe joint. Ligaments that normally hold the toe straight cause it to curl downward instead of pointing forward.
Causes Of Mallet Toes
The most common causes of mallet toes include:
- Family history
- Weakness of bones
- Muscle imbalances
- Wearing tight or pointy-toed shoes
- A deformed structure of feet
- Trauma to the feet
- An injury, jam or break in the toe
- Nerve damage or circulation problems in toes
- Foot ulcers than develop into dangerous open wounds
Symptoms Of Mallet Toes
The most obvious symptom of mallet toes is curling or bending at the toe joint nearest the toenail. Other visible symptoms of the ailment are:
- Redness and swelling on the affected toe
- Corns on or around the bent part of the toe
- Pain when wearing shoes or walking
- Toe sores or foot ulcers, especially in people with diabetes
- Toenail thickening or abrupt changes in and around nails
How Are Mallet Toes Diagnosed?
Mallet toes is diagnosed by a podiatrist. It needs a thorough physical examination of your feet to check the toe’s flexibility. Doctors also conduct a gait analysis to assess the way you walk besides determining if you are putting added pressure on the affected toe. They also perform an X-ray besides conducting debridement or removal of any painful skin or nail. Your healthcare provider may also order imaging tests to rule out fractures.
Treatment Of Mallet Toes
While people opt for conservative treatments to cure mallet toes, severe or rigid mallet toes may not respond to such therapies. Treatment for mallet toes is easier to perform if it is in a flexible state. While some rigid ones will remain bent permanently, there are many ways to relieve and prevent further complications. Surgery may be needed to restore the proper alignment of the joint. However, like all surgeries, this one also comes with potential risks. Possible complications of mallet toe surgery include infection, recurrence of the bent toe or nerve damage. Surgical options for mallet toe include:
Arthroplasty: Removing part of the bent toe bone and realigning it.
Tendon Release: Cutting a tight toe tendon to allow the toe to lay flat and become normal.
Tendon Transfer: Moving the tendon of the affected toe to another part of the foot that allows the toe to straighten.