Reversal of toe clawing in the patient with neuropathy by neurolysis of the distal tibial nerve.
The distinction between hammer toes and clawed toes is poorly emphasized. The neural origin of clawing in the foot is related to the lateral plantar nerve, and suggests that surgical treatment directed at decompression or neurolysis of the lateral plantar nerve may either reverse or prevent progression of intrinsic motor paralysis. The purpose of this report is to provide criteria to distinguish between the musculoskeletal imbalances that creates hammer versus clawing of the toes, and to demonstrate examples of improvement in clawing that resulted from neurolysis of the tibial nerve and the lateral plantar nerve.
Dellon
A Lee
AL
Division of Plastic Surgery, Department of Surgery, Johns Hopkins University, Baltimore, MD 21218, USA. ALDellon@Dellon.com
Steck
Jerome K
JK
D019299:Decompression, Surgical; D003929:Diabetic Neuropathies / Q000150:complications / Q000601:surgery*; D037801:Hammer Toe Syndrome / Q000150:complications / Q000601:surgery*; D006801:Humans; D013979:Tibial Nerve / Q000601:surgery; D016896:Treatment Outcome