HEALTH COLUMN: Toe talk: there's no need to avoid season's sandals

By Dr. David Franklin
Blount Memorial Hospital

Now that summer is in full swing, chances are most of us are trading our close-toed shoes for sandals or an open-toed design. This change in footwear means that many are getting their first good look at their toes in months and some may not like what they see.

We’re not talking about tan sock-lines or ungroomed toe nails, but rather, the various positional afflictions of the toes. The word "deformities" sounds a bit grotesque but for lack of a better word, it does fit the case.

The three most common positional abnormalities affecting the toes, also called digits, are hammertoes, contracted toes and mallet toes. In most cases, these problems develop over time and may or may not cause problems. Treatment is not always necessary.

Hammertoe deformities are partial dislocations of the digit causing a prominent knuckle or protrusion of bone on top of the toe. Often, a hardened corn will form over this prominence in response to shoe pressure. A true hammertoe deformity cannot be straightened out by manual manipulation and is considered a fixed deformity.

In contrast, a contracted digit is a toe that is drawn upward or downward because of the unequal pull of a tendon. This condition is considered flexible since, with manipulation, it can be reduced and straightened into a correct position.
Contracted toes in themselves, rarely cause problems, but they may be the cause of other problematic conditions, either on the top or the bottom of the foot.

Mallet toes, like hammertoes, are partial dislocations of bone, but involve the end or last joint of the toe instead of the first one. In this condition, the patient often walks on the end of the involved toe and forms a corn at the end and undersurface of the digit. True mallet toes are frequently problematic due to pressure and the lesion that develops on the end of the toe.

The most effective treatment in reducing and correcting these positional ailments is toe surgery. Today, various techniques and procedures are available which make the surgery relatively simple and cause only minimal discomfort during post-
operative healing. Usually, a patient is allowed to walk immediately in a special shoe, and often there is minimal interruption of the patient’s daily routine. Time required from work depends on the type of work the individual does.

Deformities of the toes occur frequently and usually they can be easily resolved in cases where they are problematic. If you suffer from deformities of the toes that affect or limit your activities, make plans to see a podiatrist and find out what treatment options would be best suited to help solve or address your particular problem.

Dr. David Franklin is a member of the American and Tennessee Podiatric Medical Associations and a podiatrist with Foothills Podiatry and Blount Memorial Hospital.

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