TOES
Robert H. Sheinberg, D.P.M., F.A.C.F.A.S., D.A.B.F.A.S.
Causes:
- Trauma to the top of the digits.
- Fractures that healed with displacement causing the joint surface to be irregular.
- Hammertoes, mallet toes or claw toe deformities that have progressed over a long period of time.
- Rheumatoid arthritis.
- Psoriatic arthritis.
Signs and Symptoms:
- The joint afflicted with them arthritis may appear to be abnormally large.
- A loss of motion of the second toe joint.
- Difficulty wearing closed shoes, especially heels.
- Diffusely tender.
- Occasionally red.
- If associated with certain types of arthritis it may appear to be significantly enlarged relative to the other toes (sausage toe).
X-rays:
- Usually, reveal joint space narrowing and deformity. May also reveal erosions of the joint indicative of underlying synovial tissue disease. May also reveal old trauma to the area that healed out of alignment.
Treatment:
- In very mild cases a steroid injection in and around the joint may significantly reduce the inflammation and pain.
- Wider shoes to accommodate the area.
- If synovial tissue disease is causing the underlying problem, medical treatment may be necessary to treat the disease process.
- Surgery to permanently correct the problem. This can include either removing or fusing the joint to completely eliminate the pain and deformity. A complete return to shoe gear and activity is usually the norm following the healing process. No long-term adverse effects have been associated with removal of the arthritic joint or fusing it.