Challenges in Offloading Lesser Toe Deformities: A Case Study

Lesser toe deformities such as hammer, mallet, claw, or cross over toe deformities are common in the elderly. They are attributed to mechanical, neuromuscular, congenital, inflammatory arthritis, or other disorders. They become clinically relevant when they produce pressure and friction at the distal ends of the digits leading to preulcerative callus or ulcer formation. These deformities can be difficult to offload with custom orthotics, accommodative footwear, and off-the-shelf devices such as crest pads and toe crutches.

Mr. D was an 82-year-old man with bilateral lesser toe deformities and a history of preulcerative callus and ulceration. This case describes use of a custom silicone molded toe prop/orthoses to offload pressure on the distal toes.

Custom silicone molded toe props/orthoses can be used to offload areas of concern because of pressure and friction with lesser toe deformities, decreasing preulcerative callus, reulceration, and pain. In this case, use of molded toe props/orthoses devices provide less costly than custom orthotics or off-the-shelf devices for patients, and they were well tolerated.