PREDISLOCATION SYNDROME (Synovitis)
By: Robert H. Sheinberg, D.P.M., D.A.B.F.A.S., F.A.C.F.A.S.
PROBLEM:
- Drifting of the second toe towards the big toe, causing pain, deformity and early development of an overlapping second toe over the big toe.
CAUSE:
- Trauma to the second toe joint causing inflammation in that region.
- Inflammation of the nerves on the ball of the foot (neuroma).
- Long second toe or second metatarsal, causing a hammertoe and excess stress on the ball of the foot.
- Weakness or tearing of the ligament holding the second toe straight.
- Pressure on the second toe from a bunion deformity.
- Pressure on the second toe due to a crooked big toe (hallux deformity).
SIGNS & SYMPTOMS:
- Visible space between second and third toe while weight-bearing.
- Pain to the second toe that increases with walking.
- Difficulty walking barefoot and unable to wear heels.
- Drifting of the second toe towards or over the first toe (overlapping toe).
- Hammertoe of the second toe.
- Neuritis (inflamed nerve causing numbness, burning and tingling).
- Associated with bunion deformity and/or crooked big toe.
- Swelling of the second toe and/or ball of the foot.
- Callus (hard skin) on the ball of the foot.
TREATMENT:
- Anti-inflammatories to decrease inflammation and stiff-soled shoes to prevent toe bending.
- Taping of the toes to lessen the pain and deformity.
- Surgery to realign the joint and possibly remove the nerve to achieve full recovery.
PROGNOSIS:
- Excellent with regard to eliminating the pain and deformity. The earlier the treatment, the better the long-term prognosis.