Toe Deformities: Bunions, Hammertoes, and Related Conditions

Most people have an idea as to how normal toes should appear- lying flat and aligned.  It can be disconcerting when you notice one or more of your toes having an abnormal bend or protrusion.

There are a couple different kinds of toe deformities, including bunions, hammertoes, and related conditions. If this is a problem for you or any of your family members, we recommend you call our clinic and schedule an appointment with Dr. Andrew Marso, an expert leader in treating these specific toe deformities.

Dr. Marso is experienced in providing effective treatment for many patients from across the greater Milwaukee County community—and he can do the same for you!

Bunions: Common Toe Deformities

Bunions are painful swellings that occur on the metatarsophalangeal (MTP) joint—the toe joint closest to the foot—found at the base of the big toe. This condition develops as the great toe is pushed against the next one. In turn, this causes the aforementioned joint to jut out and the toe to point inward.

Given that the protrusion is abnormal, most shoes are not designed to accommodate a bunion. This results in additional pressure causing a bursa—the fluid-filled sac that protects the joint—to become inflamed. Eventually, the entire joint becomes stiff and painful.

There are several risk factors and root causes that lead to a bunion forming (and can contribute to its progression). An inherited issue with foot structure is one such cause. A related problem—overpronation—is another.

High heels tend to get a bad reputation for causing bunions, but the truth of the matter is that they are more likely to cause an existing bunion to worsen, rather than be the actual cause.

LEARN MORE ABOUT BUNIONS ON THIS PAGE!

Hammertoes (and Related Conditions)

There are also three particular toe deformities that happen to be quite similar—hammer, mallet, and claw toes. These respective conditions have some common traits, but there are also certain differences as well. It is relatively easy to distinguish between these toe abnormalities:

• Hammertoes. In this case, there is an abnormal bend located at the middle toe joint. This bending results in a toe that bends down (towards the floor). Most commonly, this condition affects the second toe.
• Mallet Toes. A mallet toe is rather similar to a hammertoe, with both of these conditions having the same type of bend. The key distinction is the joint wherein the bend is located. With this deformity, the abnormal downward bend is located in the joint closest to the tip of the toe. In a similar manner as with hammertoes, this is most often seen in the second toe.
• Claw Toes. One distinction between claw toes and the other toe deformities is the fact there is an upward bending (in addition to downward ones). The upward bend happens in the metatarsophalangeal (MTP) joint, which is located at the base of the toe. The other two joints in the toe both have a downward bend (as would be the case if the previous two conditions coexisted). Additionally, all four of the smaller toes are typically impacted by this condition, instead of merely a single one.

All three of these conditions may appear unusual, but they can also be painful, make it difficult to wear shoes, and even affect your balance. Severe cases can make it hard to walk and may disrupt your natural gait pattern.

Why Toe Deformities Occur

Essentially, the underlying root cause of all these toe deformities is strength imbalance (in soft tissues), specifically with the connective tissues found in the respective joints and the muscles that control how toes lie.

For example, when either a top or bottom muscle is stronger than its opposite, the balance is thrown off and the toe bends, thereby forming a hammertoe. In the case of a bunion, there is an imbalance in the connective tissues supporting the MTP joint.

Causes for this kind of imbalance include:

• Nerve injury or disorder. When the nerves controlling these muscles are damaged—either by injury or disorder—hammertoe, mallet toe, or claw toes can develop.
• Physical trauma. Injuries resulting in jammed, stubbed, or broken toes can be responsible for a deformity developing.
• Footwear choices. There is a certain degree of debate over this in the medical community, but excessively tight shoes can force toes into curled positions. Over time, the muscles can become rigid and lead to the condition.
• Excess pressure or force. As noted earlier, overpronation—especially when combined with inherited foot structure issues—can cause and contribute to a bunion.

Treating Toe Deformities

If the affected toes still have some flexibility, a patient may benefit from simply switching to footwear that is roomier and more comfortable.

Calluses and blisters can develop when there is an abnormal bend in the toe which causes excess pressure and friction between the toe and shoe.  Proper footwear that has a deeper toe box may provide relief.  Padding and custom orthotics are sometimes used to reposition the toes, relieving pressure and pain. Beyond the shoes themselves, we can provide padding or custom orthotic devices to reposition the affected toe and relieve pressure and pain.

In some cases, when the condition is addressed at an early stage, strengthening and stretching exercises are beneficial. Dr. Andrew Marso might prescribe specific exercises for you.

When conservative care doesn’t lead to desired results, we provide an array of surgical treatment options. Depending on your specific case, we may need to release a tight tendon, remove some bone tissue (arthroplasty), perform joint fusion, or move tendons to correct the deformity.

If surgical intervention is the recommended course of treatment, Dr. Marso will take time to discuss the entire process with you so that you can feel at ease and confident in your decision, understanding the purpose and knowing what to expect.

Expert Treatment for Toe Deformities in Milwaukee County

If you are experiencing pain from any of these toe deformities—or have noticed a bunion, claw toe, mallet toe, or hammertoe condition is starting to develop—schedule an appointment with Dr. Marso for the effective treatment you need.

Did you know that our clinic has moved to a bigger and better location in Hales Corners to better serve you?  We are now located at 6130 S. 108^th St., between McDonald’s and Ritzman Appliance.  You can contact Wisconsin Foot Center to schedule an appointment at (414) 425-8400 or take advantage of our online form to schedule your appointment today.