- Not all toe deformities are painful- some can be significantly misshapen but pain free.
- Causes include trauma, inflammatory arthritis, neuromuscular and metabolic diseases.
Lesser Toe Deformities
General Advice
Symptoms and signs
- Typical toes deformities include mallet toe, hammer toe, clawing of toes.
- Pain can be exacerbated by pressure from ill-fitting shoes.
- If bony prominences not adequately protected, can cause painful corns, callous, bursae.
Initial management
- Non-surgical management focuses on relieving pressure and correcting deformity.
- Self-management advice:
- Advice on accommodating footwear: deep broad toe-box; avoid slip-on shoes, high heels and tight pointed toes
- Off the shelf plantar padding, toe protectors or supportive splints – from any chemist or on-line.
- Daily toe exercises to strengthen intrinsic muscles e.g using toes to pick up pencils and to drag a towel along the ground.
Primary Care Diagnostics
XR where clinically relevant to decision making
Useful resources
Lesser Toe Deformities (NHS Tayside leaflet)
Who to refer
- When patient has been unable to obtain suitable shoes and deformity is deteriorating
- If patient wishes to be considered for surgery
Who not to refer
- People with corns, callous or bursae who do not meet NHS Tayside Podiatry Access Criteria
- Those with no pain- surgery will not be performed for cosmetic reasons
How to refer
SCI Gateway/Orthopaedics/ Foot & Ankle Service. Referrals will be vetted by AHP and directed to most appropriate service.
Information to include when referring:
Information to include when referring:
- Duration and any cause of symptoms.
- Site/spread of pain, constant/intermittent, sleep disturbance.
- Indicate ROM, effect on walking, work/hobbies/sports,
- Include treatment to date / XR results