Retracted Toe

Retracted Toe(s)

A deformity of the toe where the PIPJ and the DIPJ are in a flexed position, and the MTPJ is dorsiflexed. This differs from the claw toe because of the MTPJ involvement

Aetiology:
(Similar to claw toes); Inappropriate footwear – narrow toe box, inadequate dept of toe box, too short, too small; Familial predisposition/inherited factors; Neuromuscular disorders

Clinical Features:
Many are asymptomatic
Apex of toe generally does not weightbear
Pressure from footwear may cause bursal development over the IPJ, especially the fifth. Associated with the bursa may be a fistula and sinus.
May be hyperkeratotic lesions associated with the pressure on DIPJ and apex of joint.
May be pain secondary to arthritic changes

Management:
Treat inflammatory states and reduce hyperatotic lesions.
Protective padding if fixed.
Corrective padding or splints if flexible
Surgery
Footwear advice.

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