Difficulty walking, inflammation, pain and discomfort when wearing shoes are the hallmarks of claw toes, a deformation of the fingers that take on an unnatural curvature. It is a condition that, like hammertoes, is extremely common

What are claw fingers?

Claw fingers are a deformity of the fingers and toes (usually on the 2nd, 3rd and/or 4th fingers), which become bent and contracted, resulting in a limitation of extension and the characteristic ‘claw’ appearance, ‘griffe’ in French.

They are often associated with a:

• imbalance of the foot muscles;
• neurological deficit.

Claw foot

This condition predominantly affects the foot and often occurs in conjunction with other disorders such as:

• hollow foot, a malformation resulting in a foot sole that is more arched and curved than normal, the opposite of which is flat foot;
• hallux valgus, a lateral and external displacement of the bone at the base of the big toe.

Claw toe

Less common, but fairly widespread, is claw-finger pathology of the hand, which involves a deformity that can lead to not only motor disturbances, but often also to sensibility, preventing patients from

• pick up an object on the ground
• exerting force.

Treatments for claw fingers

The treatment of claw toes varies according to its severity, depending on which therapy is most appropriate, which can be

• conservative, for the mild form
• surgical, for more serious forms.

Conservative therapy for claw toes

To limit the inflammation induced by the pathology in the mild to moderate forms, the doctor may

• prescribe brief drug therapy
• resort to analgesic and anti-inflammatory techniques, such as oxygen-ozone therapy which, by means of subcutaneous infiltrations of a mixture of the natural gases oxygen and ozone, enables a reduction in pain.

These therapies can be accompanied by the use of customised pads and braces that

• straighten the affected joints;
• in the case of the feet, prevent rubbing against the shoe.

The best exercises for claw toes

In addition to braces and medication, the physiatrist recommends simple exercises to

• prevent a worsening of the clinical picture
• strengthen the muscles of the affected limb.

These are exercises in series, lasting 3 to 5 seconds each, to be performed regularly and can also be used as post-operative rehabilitation in cases of surgery:

exercise 1: cut a high, not too soft sponge into thick rectangular blocks to be inserted between the fingers, which you close and re-open by pressing against the rectangles;

exercise 2: place a thick rubber band around the palm of your hand or instep and move it to the height of your fingers. In this position, spread your fingers to try to stretch the elastic;

exercise 3: sitting on a chair, feet together, lift one heel until only the toes (half toes) remain attached to the floor. Remain like this for a few seconds, then lift the toes at the tip, like dancers, and finally, after a few seconds, gently drop them forward. Once this stage is completed, get up from the chair and take a few steps walking on half toes;

exercise 4: the well-known ‘towel exercise’ consists of placing a towel on a flat surface and grasping it by lifting it towards you with your fingers or toes;

exercise 5: place small stones and place them on the floor or table and then try to pick them up with your fingers or toes and place them inside a bowl;

exercise 6: place your hands or feet on a flat surface and spread your hand, trying to pinch your fingertips;

exercise 7: insert a not too large and not too soft stress ball under the phalanges of your hands and feet and apply gentle pressure with your fingers. Then try to catch it and, in the case of a hand exercise, throw it in a jerk;

exercise 8: Place the palms of the hands upwards on a flat surface, such as a table, then try to close one finger at a time towards the palm of the hand and then open them again one at a time;

exercise 9: place one hand on a flat surface, such as a table, palm upwards and with the other help flex each finger upwards and the back of the hand placed on the table;

exercise 10: sit with your legs close together and tense, then stretch your fingers towards your toes and vice versa.

Surgery for claw fingers

The surgical correction of claw toes can be performed using minimally invasive techniques that do not involve cutting and that aim to realign the joints, mainly

• repositioning or surgically sectioning retracted tendons;
• filing, reshaping and/or fixing joint bones.

The stages and type of surgery vary depending on the:

• complexity of the pathology;
• number of fingers to be corrected.

The causes of jawed fingers can be various:

• trauma;
• rheumatological diseases, such as rheumatoid arthritis;
• incorrect foot positioning due to other pathologies, such as hallux valgus or hollow foot;
• neurological pathologies, such as neuromuscular or cerebral palsy;
• diabetes, which can lead to diabetic peripheral motor neuropathy, causing loss of muscle tone and atrophy of the foot.

Diagnosis

The diagnosis is clinical and is mainly based on the objective examination, which can be carried out by the physiatrist or orthopaedic specialist.

Claw toes, in fact, are a deformity that can already be detected visually and, if the diagnosis needs to be supported, can also be confirmed with X-rays.

What is the difference between claw, hammer or hammer toes?

The pathology of claw fingers is often identified with that of hammer and hammer toes.

In reality, these are similar problems that, however, affect different joints and, specifically:

• claw fingers affect the entire finger;
• hammertoes involve the proximal and middle phalanx of the fingers, i.e. not the outermost, peripheral phalanx, but the next two ‘innermost’ phalanxes;
• hammertoes involve only the distal phalanx, i.e. the outermost phalanx, also known as the third phalanx.

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Source:

GSD