Jamie L. Lynch, M.D. - Orthopaedic Surgeon
Northeast Orthopaedics & Sports Medicine - Jamie L. Lynch, M.D. - Orthopaedic Surgeon
 

Patient Info

Common Toe Deformities

Common Toe Deformities

Toes are the digits in your foot and are associated with walking, providing balance, weight-bearing and other activities. A variety of toe deformities occur in children's feet. They are as follows:

  • Hallux Valgus: Hallux valgus is a common toe deformity in which the child's great toe is shifted laterally and lies over the second toe. The first metatarsal bone is deviated towards the medial side causing a prominence over the medial aspect of the metatarsophalangeal (MTP) joint. A fluid filled sac (bursa) may form over this prominence which may result in a painful bunion caused by continuous irritation and inflammation. Foot pronation (flat feet) may sometimes be associated with this condition.

    The factors that cause hallux valgus include structural foot anomaly that may or may not be hereditary and use of narrow shoes that curl or fold the toes. Children having hallux valgus may not have any symptoms most of the times and do not require any treatment. Your doctor may advise shoes that have good amount of space for the toes and no heels. If there is flat foot then a shoe insert may help to prevent its progression. Surgery may be recommended only in severe cases.
  • Mallet Toe: Mallet toe refers to the downward bending of the third joint or distal interphalangeal joint (DIP) giving it a mallet-like appearance. Corns or calluses may develop over the deformity as a result of constant friction against the footwear. Mallet toe can be inherited or may develop from wearing shoes that are too tight or high-heeled.
  • Claw Toe: Claw toe is a rare deformity but occurs in association with cavus foot, Charcot-Marie-Tooth disease or myelomeningocele. It affects all the toe joints and results from hyperextension of the metatarsophalengeal (MTP joint or 1st joint) and flexion at the PIP (2nd joint), and DIP (3rd joint) joints. It results from altered structural anatomy and /or neurologic disorder that cause muscle imbalances.
  • Polydactyly: It is a condition in which there is an extra digit present in the feet. The great toe or the fifth toe is usually affected. It may occur in association with other congenital anomalies or as an isolated problem. If the extra digit does not cause any problem, it may be left alone without any treatment. Surgical excision of the extra digit will be done in cases where there is an extra little or big toe that is prominent causing difficulty in wearing shoes. Surgery is usually done after the age of 9-12 months.
  • Syndactyly: Syndactyly is the presence of fused digits and may occur along with other congenital anomalies or as an isolated problem. It rarely causes any problems and does not need any treatment. The connection between two or more toes varies from a thin skin attachment to a bony attachment (synostosis) between the phalanges.
  • Bunionette (Tailor Bunion): Bunionette is less common and occurs at the fifth MTP joint. When this occurs, the fluid sac over the lateral side of the fifth MTP joint becomes prominent and inflamed causing pain. Padding is done to relieve the discomfort. If this does not help, surgical correction will be needed.

Ankle Sprain

Ankle Sprain

A sprain is stretching or tearing of ligaments, which connect adjacent bones in a joint and provides stability to the joint. An ankle sprain is a common injury and occurs when you fall or suddenly twist the ankle joint or when you land your foot in an awkward position after a jump. It most commonly occurs when you participate in sports or when you jump or run on a surface that is irregular. Ankle sprains can cause pain, swelling, tenderness, bruising, and stiffness, numbness in the toes, and inability to walk or bear weight on the ankle.

The diagnosis of an ankle sprain is usually made by asking the history of injury and physical examination of the ankle. X-ray of your ankle may be needed to confirm if a fracture is present.

The most common treatment recommended for ankle sprains is rest, ice, compression and elevation (RICE).

  • Rest: You should not move or use the injured part to help to reduce pain and prevent further damage. Crutches may be used that help in walking
  • Ice: An ice-pack should be applied over the injured area up to 3 days after the injury. You can use a cold pack or crushed ice wrapped in a towel. Ice packs helps to reduce swelling and relieve pain. Never place ice directly over the skin
  • Compression: Compression of the injured area helps to reduce swelling and bruising. This is usually accomplished by using an elastic wrap for few days to weeks after the injury
  • Elevation: Place the injured part above heart level to reduce swelling. Elevation of an injured leg can be done for about 2 to 3 hours a day

The doctor may also use a brace or splint to reduce motion of the ankle. Anti-inflammatory pain medications may be prescribed to help reduce the pain and control inflammation.

You may need to use an ankle brace or wrap to support and protect your ankle during sports activities. Avoid pivoting and twisting movements for 2 to 3 weeks.

To prevent further sprains or re-injury you may need to wear a semi-rigid ankle brace during exercise, special wraps, and high-top tennis shoes. A program of ankle exercises will also help to prevent re-injury by making the ankles strong and flexible.

American Academy of Orthopaedic sergions - Jamie L. Lynch, M.D. - Orthopaedic Surgeon Arthroscopy Association of North America - Jamie L. Lynch, M.D. - Orthopaedic Surgeon AOSSM - Jamie L. Lynch, M.D. - Orthopaedic Surgeon THE PERRY INITIATIVE - Jamie L. Lynch, M.D. - Orthopaedic Surgeon
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