Hammertoes/Clawtoes: metatarsophalangeal joint correction

Area of Science:

• Orthopedics
• Podiatry
• Foot and Ankle Surgery

Background:

• Lesser toe deformities, such as clawing, are common and frequently linked to other forefoot abnormalities.
• Nomenclature for deformities affecting the metatarsophalangeal joint (MTPJ) and proximal interphalangeal joint (PIPJ) can be confusing.
• These deformities may represent a unified pathological process, suggesting similar treatment approaches.

Purpose of the Study:

• To clarify the nomenclature and understanding of lesser toe deformities affecting the MTPJ and PIPJ.
• To outline the treatment spectrum for lesser toe deformities, from conservative to surgical options.
• To describe stepwise surgical correction strategies for MTPJ deformities.

Main Methods:

• Review of existing literature on lesser toe deformities and their management.
• Analysis of treatment outcomes for both nonoperative and operative interventions.
• Description of a stepwise progression of surgical techniques for MTPJ correction.

Main Results:

• Nonoperative methods are effective for many cases of lesser toe deformities.
• Surgical options are available when conservative treatments fail.
• Correction of MTPJ deformities can be achieved through soft-tissue procedures, bony procedures, or a combination.

Conclusions:

• Lesser toe deformities are multifactorial and often associated with forefoot issues.
• Despite nomenclature confusion, a unified approach to treating MTPJ and PIPJ deformities is often applicable.
• A stepwise approach, progressing from soft-tissue to bony procedures or combined methods, allows for effective MTPJ correction.