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Foot & Ankle
intermediate
X-Type

Claw Toes - FDL Transfer, PIP Fusion, and Lesser Toe Deformity Management

Claw Toes

A 58-year-old woman with diabetes presents with painful callosities on the tips of her 2nd, 3rd, and 4th toes and under the corresponding metatarsal heads. Examination reveals hyperextension of the MTP joints with flexion at both the PIP and DIP joints of all affected toes. She cannot actively straighten the toes. When the examiner pushes up on the metatarsal heads (Kelikian push-up test), the toe deformity partially corrects at the MTPJs but the PIP joints remain flexed. She has reduced protective sensation bilaterally. Regarding the anatomy and classification of lesser toe deformities:

Mark each as TRUE or FALSE

A

CLAW TOE is defined as MTPJ HYPEREXTENSION combined with PIPJ FLEXION and DIPJ FLEXION; this differs...

B

Claw toe pathophysiology involves INTRINSIC MUSCLE WEAKNESS (lumbricals, interossei) with intact EXT...

C

Claw toe and hammer toe are identical deformities with the same treatment; the DIP joint is always f...

D

The KELIKIAN PUSH-UP TEST assesses MTPJ flexibility: pushing up on the metatarsal heads from plantar...

E

Pressure complications in claw toes occur at: (1) DORSAL PIPJ (from shoe rubbing), (2) TIP OF TOE (f...

Answer the questions to see explanations

Click T (True) or F (False) for each option