MALLET TOE
A mallet toe is a foot deformity that occurs due to an imbalance in the muscles, tendons, or ligaments that normally hold the toe straight. The type of shoes your child wears, foot structure, trauma, and certain diseases can contribute to the development of these deformities.
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Mallet Toe
The ailment known as mallet toe occurs when the end of the toe is bent and does not straighten. There are two distinct forms of mallet toe: stiff mallet toe, which involves misaligned joints and tightened tendons and typically causes greater symptoms; and flexible mallet toe, in which the afflicted toe joints are still mobile. Mallet toe might have a number of reasons for developing.
Shoes that are overly tight, especially those with narrow toe areas, osteoarthritis, stress to the toe after an accident, and imbalances in the toes’ muscles and tendons are a few of these. Mallet toe has a number of risk factors, including gender, age, diabetes, and toe length, which might affect the likelihood of acquiring the condition — especially, if your child’s big toe is shorter than his or her second toe. Girls are also considerably more prone to have the ailment than boys.
What are the Symptoms of Mallet Toe?
Calluses and corns, typically brought on by friction with a shoe, swelling, and redness of the afflicted toe, and toe ulcers, particularly in diabetic people, are typical signs of mallet toe. This condition can cause pain and limited toe mobility as a result of the aforementioned symptoms. Mallet toe has a joint that bends abnormally, which gives it a certain unnatural look.
Progressive Issues Result in Chronic Pain and Complications
Early on, children might be able to partially straighten their toe and just notice that it looks a bit off. However, a mallet toe is a degenerative ailment, and therefore, without treatment, the symptoms will not improve. Your child will feel more discomfort as the injury increases and find it more and more difficult to locate shoes that fit. Bent toes can easily cause painful friction sores like blisters or corns by rubbing against the inside of shoes. In the worst circumstances, your child can even have balance issues or difficulties walking.
QUESTIONS AND ANSWERS
What constitutes mallet toe, and how does it occur in children?
- Mallet Toe: A mallet toe refers to an improper condition of the toes. With a mallet toe, the distal joint of a child’s toe becomes bent in a downward direction. Otherwise, the tip of the toe points downward. This can affect any toe, but it most commonly affects the second, third, or fourth toe.
- Causes: The cause of Mallet toes in children stems from a variety of factors. These factors include genetics, ill-fitting footwear, muscle imbalances, or underlying medical conditions. The condition may develop gradually over time or occur at birth.
How do doctors diagnose and treat mallet toe in children?
- Diagnosis: Diagnosis involves a physical examination by a healthcare provider, who assesses the toe’s appearance and range of motion. In some cases, doctors will order imaging studies, like X-rays to assess the extent of deformity and rule out any underlying issues.
- Treatment: Treatment options for mallet toe in children may include:
- Toe Exercises and Stretching: Simple exercises and stretches to improve flexibility and joint alignment.
- Orthotic Devices: Wearing orthotic devices, toe splints, or cushions may help reduce discomfort and prevent the condition from worsening.
- Proper Footwear: Encouraging children to wear footwear that accommodates the mallet toe and provides ample space for the toes can help alleviate pressure and discomfort.
- Surgery (Rare): In severe cases where other treatments have been ineffective and the deformity significantly affects the child’s quality of life, doctors will recommend surgery to correct the toe’s alignment.
What is the long-term outlook for children with a mallet toe, and can it lead to complications?
- Outlook: With early diagnosis and appropriate management, children with a mallet toe can expect good outcomes. The goal of treatment is to alleviate discomfort, improve toe alignment, and prevent the condition from worsening.
- Complications: If left untreated, a mallet toe can lead to ongoing discomfort, pain, and difficulty fitting into footwear, potentially impacting a child’s mobility and overall foot health.
Parents who suspect their child has a mallet toe should consult a healthcare provider. Early diagnosis and intervention are crucial for ensuring the best possible outcome and reducing the risk of complications associated with this condition.
When children break bones or tear ligaments, parents need to take them to the very best doctors. At the Medical City Children’s Orthopedics and Spine Specialists, we are the best. We specialize in children and their bones and ligaments.
Diagnosis
Diagnosing a mallet toe typically begins with a thorough medical history and physical examination by a qualified healthcare professional, often a podiatrist or orthopedic specialist. During the examination, the doctor will assess the patient’s foot alignment and mobility, paying particular attention to the affected toe. They will look for visible deformities, changes in the toe’s angle, and any accompanying symptoms such as pain or discomfort. In some cases, the doctor may request X-rays to further evaluate the extent of the deformity and rule out other underlying conditions. This comprehensive assessment helps the healthcare provider to determine the severity of the mallet toe and develop an appropriate treatment plan, which may include both conservative measures and, in more severe cases, surgical intervention. Early diagnosis and intervention are essential for the effective management of mallet toe and for preventing further complication
Fix Mallet Toe Without Surgery
The extent of your child’s illness will determine how our doctors will treat the mallet toe or toes. For less severe cases, mallet toe treatment may only need switching to low-heeled, roomier shoes and potentially adding some shoe inserts, arch supports, or toe tubes that keep the foot in a more comfortable posture and provide support for the bent toes. If your child’s toe(s) still have some flexibility, you might want your child to try wearing a mallet toe splint or brace. In milder circumstances, buddy taping can also serve as a straightener. In addition to choosing more suitable footwear, there are several mallet toe exercises your child may perform to strengthen and stretch the toe muscles. Using toes to pick up marbles or crumpling a towel are a few examples.
Will My Child Need Toe Surgery?
Conservative treatments might not be effective for severe or inflexible mallet toes. Toe surgery may be required in some cases to realign the joint properly. The following surgical options can help:
- Arthroplasty: realigning and removing a portion of the twisted toe bone.
- Tendon release: Cut the tight toe tendon so that the toe is flat.
- Tendon transfer: To make the mallet toe straighten, move the tendon in that toe to a different area of the foot.
Other Options for Surgical Treatments
Most children with mallet toes do not require surgical treatment. However, if the pain associated with the Mallet Toe is particularly severe, surgery may be required. Some teenage girls may also want to have surgery for cosmetic reasons. However, surgical treatment may be contraindicated. These include conditions such as active infections, psychiatric disorders, and vascular disorders. Our pediatric orthopedic specialists may recommend surgery to treat pain when conservative treatment does not help.
Flexible Mallet Toe:
Repairing the tendon from the toe’s base to its projection via a tendon transplant operation solves the issue. This aids in straightening the flexed joint.
Stiff Mallet Toe: There are Two Choices for Treatment:
A) Joint resection
Atherectomy can be used to treat a fixed Mallet Toe by making an incision on the top of the toe. Our surgeons can straighten your child’s toes by cutting ligaments and tendons. Remove the end of the bone so that the toe is perfectly straight and temporarily use a pin to keep the toe straight. Pins are usually removed 3-4 weeks after surgery.
B) Fusion:
It can even be used to treat a set Mallet Toe by cutting the ligaments and tendons and straightening the toe. The tip of the bone is interrupted to straighten the toe. Pins, screws, or alternative implants will be accustomed to keep the toe straight.
Mallet Toe Exercises
Your child may conduct certain physical therapy activities to aid with the problem. Our doctors can provide several exercises that help restore the toe to its proper position.
The Toe Stretch
In order to reduce the symptoms of the ailment and make the mallet toe easier to deal with, stretching your child’s toe can help make the joint more flexible.
- The parent should hold the afflicted toe gently.
- Stretch the toe in the direction that it is not bent.
- One joint at a time, continue until there is a gradual, gentle pull.
As often as your doctor advises, perform this many times each in the morning and at night.
The Towel Exercise
In addition to extending the injured toe, this exercise helps it gain strength. The mallet toe benefits from this exercise and becomes more flexible.
- Furthermore, doing it is really simple.
- Lay a towel out flat on the ground.
- Fold the towel using the whole toes of the afflicted foot.
Repeat as often as a doctor instructs.
The Marble Exercise
This is quite similar to the towel exercise, except instead of using a towel, your child uses marbles. This exercise is much better for increasing the flexibility of your child’s afflicted toe because it calls for greater dexterity and control of the toes.
- Put a marble or several marbles on the ground.
- Have your child pick them up with the toes of the injured foot.
- As many times as a doctor instructs.
Footwear Helps Treat Mallet Toe
Wearing a shoe insole made for the problem is one of the best things a parent can do to treat a child’s mallet toe. By more evenly dispersing the pressure that the bent toe might put on your foot, these insoles assist in lessening the pain and discomfort. By improving the fit of the shoes, shoe insoles can also aid in the prevention of this condition and many more. Since wearing shoes that don’t fit properly is one of the primary causes of mallet toe, changing your child’s shoes for a shoe insole will help feet fit better, provide more support, and make your child feel more at ease in their footwear.
Call the Best Children’s Doctors
If your child suffers from a Mallet Toe or any foot condition, you should call and make an appointment with one of our children’s doctors at Medical City Children’s Orthopedics and Spine Specialists. We have offices in Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX.
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Footnote:
American Academy of Orthopaedic Surgeons: Mallet Toe
Call 214-556-0590 to make an appointment.
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