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Hammer Toe, Crossover Toe: Different Diagnoses

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A new patient appeared at the clinic a few months ago. At first, she said, her second toe’s hitching a ride on the big toe was a source of amusement to her and her family. She was less amused when she had to stop wearing open-toed sandals.

Hammer Toe, Crossover Toe: Different DiagnosesNow the condition was causing real discomfort. It felt like there was a balled-up sock under her foot, and she could no longer walk comfortably for any length of time.

Crossover toe is one of those overlooked afflictions. Patients say they never heard of it— until it affects them.

The bad news for our patient was that her options were narrowing with each passing month.

If she had come in when the condition first started, when it was still a funny thing to show her grandchildren, more options might have been available to slow the progress.

Many people confuse crossover toe with hammer toe, which is more common. They are actually quite different, with different causes and each demanding a different clinical approach.

Hammer Toe or Crossover Toe?

Differentiating between hammer toe and crossover toe can be tricky, especially in the early stages when the conditions are most treatable.

With hammer toe, the following signs may be present:

  • a toe (usually the second) starts to curl downward into a claw-like form
  • a corn or a callus may develop
  • walking may be painful
  • patients have trouble wiggling the toes

We can diagnose hammer toe with a physical exam. X-rays may help show any damage to the bone, muscle or ligaments in the foot.

Crossover Toe can be a Real Crippler

A crossover toe shares some of the same signs, but the final outcome is quite different. Folks with crossover toe may find it difficult, eventually, to wear shoes. Their gait may be hampered by the dislocated joint.

It’s generally thought that crossover toe is a result of an abnormal foot structure, which may be worsened by gait mechanics.

Both conservative and surgical treatments work best when applied in the early stages. If crossover toe is not corrected, it may lead to severe bunions, arthritis of the big toe known as hallux rigidus, a longer-than-normal second metatarsal (long bone in the foot), a second toe that extends beyond the big toe, an unstable arch or tight calf muscle.

Every structure in the foot has an effect on other bodily structures so a deformity such as crossover toe should not be ignored.

We advise our patients to have their feet checked regularly. If they see any unusual tendencies, we encourage them to call for an appointment at one of our branches in DeSoto, Dallas and Sunnyvale.

Treatment of Hammer Toe or Crossover Toe

Hammer Toe, Crossover Toe: Different Diagnoses

Both conditions require a thorough clinical exam. Doctor will also ask about the history of the problem and the patient’s lifestyle.

X-rays, ultrasound or MRI may be ordered to assess the structure of the foot as well as possible damage to the cartilage.

Because the symptoms of crossover toe may be similar to those of Morton’s neuroma, it’s important to get an accurate diagnosis. Then we can discuss treatment options.

The discomfort of hammer toe may be relieved by pads or insoles that fit into the shoe. If these measures fail to bring the desired relief, there are surgical techniques to reposition the toe, removed any damaged bone, and realign the tendons. Surgery is usually done on an outpatient basis.

For its part, crossover toe is progressive and not reversible. This means that the toe will not return to its normal position. However, we can use a combination of bracing or taping, as well as special orthotics, to slow the progress of the condition.

If surgery is deemed advisable, it may be possible to repair the plantar plate. Your doctor will explain the recovery time, as well as what to expect after surgery.

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