Due to the propaganda of the media, people all know that bones and joints will degenerate. The degradation of bones is osteoporosis, and the degradation of joints is degenerative arthritis. There are relative commodities on sale. Because there is no commodity to sell, the concept of tendon degeneration has not been popularized. Therefore, people often ignore that tendon degeneration is also one of the culprits of claw toes. Kevin Chu, a famous doctor specializing in ankle surgery, shared in the book Save Your Foot Pain that modern people have no chance to exercise their toes, especially the little toes other than the big toes are idle for a long time. After a long time, the tendon naturally degenerates and loses its balance, which is easy to produce claws and toes.
The pain of claws and toes mostly comes from toe arching, toe joint rubbing shoes, or increased pressure under the arch. These two aspects can be alleviated by some methods, such as wearing special insoles or loose shoes; As for aesthetic considerations, many older people don't care because their toes are covered by shoes.
Amputation may seem like a simple choice, especially for the elderly with mobility difficulties, but we should not amputate functional limbs unless absolutely necessary, and amputation of one toe may cause distortion of the other toe, just like tooth arrangement without one tooth. The treatment of claw toe involves the balance of internal muscles, external muscles, joints and many other aspects, in fact, all aspects of consideration are very complicated. Because claw toe is one of the syndromes caused by different causes, we should first explore its cause and then treat it according to it. Claw toes can be divided into three major causes: degeneration, trauma and neuropathy: etiology 1: tendon degeneration. This kind of claw toe caused by tendon degeneration of little toe can be improved by exercising toes every day. If it is not improved for a long time, it can be improved by some tendon transposition or release surgery. But before the operation, it is suggested to do self-rehabilitation and toe exercise first, exercise your toes more when you have time, and try to catch your toes. As long as the function does not degenerate to rigid contracture, toe movements like this usually improve a lot without surgery. But remember, toe movement must continue! Never fish for three days and dry the net for two days. Reason 2: the release of paw and toe muscles caused by trauma is simple and quick. Some people suffer serious injuries to their feet, such as broken bones. After reduction and fixation, the wound seems to be healing gradually, but I didn't expect claw toes to appear again two or three months later. This is because after severe trauma, the soft tissue is seriously damaged, and bleeding fills a cavity of the calf, resulting in hypoxia, muscle atrophy and contracture, resulting in claw-toe phenomenon (cavity syndrome). In this case, the doctor will recommend muscle release.
Some doctors may lack the training of foot and ankle specialty, and relax directly from the toes when they see the claws and toes. This method not only gets twice the result with half the effort, but also has great trauma and poor postoperative effect. In addition to confirming the position, we should also consider whether the patient still has the problem of muscle structure imbalance caused by trauma. If so, we must do some bone shortening or joint plastic surgery.
Reason 3: the treatment of claw and toe caused by neuropathy varies from person to person. "Neuropathy", as its name implies, is a phenomenon caused by disharmony of nerves in the feet caused by nervous system diseases, such as polio, cerebral palsy, diabetic foot (because diabetes will destroy motor nerves) and so on. This type of claw-toe treatment is the most complicated, because its etiology involves a wide range, and claw-toe phenomenon is only a small part of the whole series of problems. In addition to the symptoms of claw toe, there may be many problems such as joint contracture of vertical foot and tendon. In addition to a wider range of tendon displacement and release, it must also be considered that patients may be used to landing on their forefeet because of vertical foot contracture. If it is corrected into a normal flat foot, the length of the foot will be shortened, and the strength of some tendons may be insufficient, which will affect the function of the ankle in the future. Feet are not only big toes and little toes, but also very important. In the ankle branch, once the hindfoot organs, such as ankle joint, subtalar joint and calcaneus, are damaged, the pain will generally be higher than that of the forelimb organs, and the mobility will be immediately affected. Therefore, hindfoot diseases are generally paid more attention than forefoot diseases. As for the forefoot, everyone's eyes are mostly focused on the big toe, and relatively speaking, the other toes can get little care. However, with the improvement of quality of life and functional awareness, people pay more and more attention to the symptoms caused by "little toe disease". In recent years, the topic discussed by Taiwan Province Foot and Ankle Medical Association has changed from hind foot and big toe to "little toe disease", including symptoms such as paw toe and sole pain. Dr. Kevin Chu said that he was very happy to see such a change, because paws and toes were often placed at the end of treatment and were ignored by people, but there was very profound knowledge in them. If both doctors and patients don't understand deeply and don't know how to explore the complicated reasons behind it, it will be difficult to get good treatment results.