| Introduction |
 Mallet deformity is characterized by
- hyperflexion of the DIP joint
- Deformity may be
- isolated or in conjunction with claw toe
- Pathoanatomy
- contracture (or spasm) of FDL
- > 70% of patients have a longer digit
- Congenital mallet toe
- associated with flexion and lateral deviation of the DIP joint
|
| Anatomy |
| |
Claw Toe
|
Hammer Toe
|
Mallet Toe
|
| |
 |
 |
 |
| DIP |
flexion
|
normal
|
flexion
|
| PIP |
flexion
|
flexion
|
normal
|
| MTP |
hyperextension
|
normal (slight extension)
|
normal
|
|
| Presentation |
- Physical exam
- callosities on toe
- dorsum of the DIP
- tip of toe; pain results from impacting the ground with gait
|
| Treatment |
- Nonoperative
- shoes with high toe boxes, Silicone/foam toe sleeves
- Operative
- percutaneous FDL tenotomy
- indications
- flexible deformities that have failed nonoperative management
- middle phalangeal distal condylectomy (excisional arthroplasty of DIP)
- indications
- rigid deformities that have failed nonoperative management
- technique
- repair attenuated extensor tendons
- K wire placement used to hold affected digit in extension
|