Objective: The aim of this study was to analyze the prevalence of claw toes and its correlation to other lower limb disorders as well as the global functional recovery in a population of hemiplegic patients 1year post-stroke.
Patients And Methods: This prospective study included 39 stroke patients hospitalized in the Physical Medicine and Rehabilitation (PM&R) department of a hospital between September2000 and September2001. The evaluation looked for incidence of claw toes during the first year post-stroke and whether there was a potential link to triceps surae spasticity, motor impairment of the leg and patients' functional abilities (Barthel Index, postural assessment scale for stroke patients [PASS], functional ambulation classification [FAC]).
Results: We conducted a total of 64 evaluations (one to four by patient). In 18 out of 39 (46%) patients, we found an occurrence of claw toes. In 15 out of 18 (83%) patients, who regained average functional capacities, its onset took place before the end of the third month post-stroke (Barthel: 30-70, PASS: 15-33, FAC: 3-4) and it was significantly linked to equinus and/or varus foot (p<0.0001).
Conclusion: The occurrence of claw toes in hemiplegic patients is common and happens early on post-stroke. Equinus and/or varus foot and average functional capacities were associated to claw toes. Despite the few studies devoted to this condition in stroke patients, this condition must be diagnosed early and taken into account to improve the patient's rehabilitation care.
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http://dx.doi.org/10.1016/j.rehab.2009.12.005 | DOI Listing |
BMJ Open Diabetes Res Care
December 2024
Steno Diabetes Center Copenhagen, Herlev, Denmark.
Introduction: The aim of this study was to evaluate the effects of flexor tendon tenotomy treatment of the diabetic hammertoe deformity on plantar pressure.
Research Design And Methods: The study was a substudy including participants from a randomized study on tenotomy treatment of diabetic hammertoes. This study was conducted between December 20, 2019 and June 22, 2021.
Clin Podiatr Med Surg
January 2025
The London Clinic, 20 Devonshire Place, Marylebone, London W1G 6BW, UK. Electronic address:
Hammer toe deformity is a highly prevalent lesser toe deformity and accounts for a high proportion of appointments to foot and ankle clinics. Its etiology is due to extrinsic and intrinsic muscular imbalance, attenuation and subsequent rupture of the plantar plate, and neuromuscular disorders. This leads to marked flexion of the proximal interphalangeal joint and extension of the metatarsophalangeal joint.
View Article and Find Full Text PDFMusculoskelet Surg
November 2024
Circolo Hospital, Macchi Foundation 'Insubria University', Viale Borri 57, 21100, Varese, Italy.
Forefoot disorders are prevalent in the general population, with an incidence between 2 and 20%. Among them, lesser toe deformities (hammer, claw, and mallet toes) are frequent disorders, and their conservative management is often not adequately considered but usually attempted before surgical indication. Among conservative treatments, shoe modifications and the application of orthoses may, in most cases, alleviate symptoms.
View Article and Find Full Text PDFFoot Ankle Clin
December 2024
Department of Orthopaedic Surgery, Baylor University Medical Center, 3900 Junius Street, Suite 500, Dallas, TX 75246, USA; Foot and Ankle Surgery Fellowship Program, Baylor University Medical Center, Dallas, TX, USA.
Successful lesser toes and metatarsophalangeal (MTP) joint reconstruction must withstand substantial biomechanical loads from standing, walking, and exercise. While complications following lesser toe and MTP reconstruction are common, limited literature addresses revision surgeries for complications including recurrence. Numerous complications of surgery for toes and lesser MTP joints can be managed or improved through revision surgery, but not all complications can be prevented or resolved.
View Article and Find Full Text PDFFoot Ankle Clin
December 2024
Department of Orthopaedics and Traumatology, North District Hospital, 9 Po Kin Road, Sheung Shui NT, Hong Kong SAR, China. Electronic address:
Instability of the lesser toes metatarsophalangeal (MTP) joints is a common forefoot problem and can present as metatarsalgia, synovitis, and lesser toe deformities. The plantar plate contributes to MTP joint stability through its interaction with the plantar aponeurosis, and plantar plate insufficiency is the primary cause of MTP joint instability. Conservative treatment options, including the use of nonsteroidal anti-inflammatory medications, intra-articular steroid injections, orthosis, and accommodative shoe modifications, generally provide only temporary relief and do not effectively halt the progression of deformity in most cases.
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