Shoes With Toes

A mallet toe consists of plantar flexion of the distal interphalangeal, and neutral position of metatarsophalangeal and proximal interphalangeal joints (Figure 3.26).

Toe deformities (hammer, claw, curly, mallet toe and overriding of toes) are unknown in non-shoe wearing populations. Their incidence varies from 2 to 20%, and increases with age. Women are affected four to five times more often than men.

Most people have no underlying disease, although neuromuscular diseases and inflammatory arthropathies may be accompanied by such toe deformities.

Toe deformities are more common in people with diabetes, due to muscle atrophy and limited joint mobility. Deformities such as those described above, when present in a patient with loss of sensation due to diabetic neuropathy, pose a risk for the development of neuropathic ulcers, as prominences are susceptible to skin-on-shoe friction. Patients are instructed to check their feet every day. Shoes with a high toe box protect the deformed toes from ulceration.

Deformed Toes Shoes
Figure 3.22 Hallux valgus, toe overriding and Figure 3.24 Mild hallux valgus and hammer

onychomycosis toe deformity on the right second and third toes, with a superficial ulcer on the dorsum of the second toe. Right foot of the patient whose feet are shown in Figures 3.22 and 3.23

Diabetic Foot Deformity
Figure 3.23 Hammer toe deformity of the second, third and fourth toes, hemorrhagic callus and onychomycosis. Anterolateral view of the foot shown in Figure 3.22
Diabetic Dermopathy Feet

Figure 3.25 Hammer toe

Mild Superficial Diabetic Ulcer
Figure 3.26 Mallet toe

Keywords: Mallet toe; toe deformities

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