DYNAMIC CLAW TOE DEFORMITY - ITS SURGICAL MANAGEMENT

INTRODUCTION Checkrein deformity dynamic flexion deformity of toes, is a fixed length phenomenon of the long toe flexors secondary to tethering of FHLFDL or both. Etiology- may be due to contracture of the muscles of the deep posterior compartment of the leg after compartment syndrome or the muscle bellies of the tendons have been injured or trapped at the site of the fracture or in callus of distal tibia, talus or calcaneum or scarred after a local haematoma. We report a case of acquired claw toe, a late consequence in fracture shaft of tibia treated by intramedullary interlocking nail MATERIALS AND METHODS A 24 year old male patient had painful clawed toes with disturbance of gait and discomfort in shoes. On examination, patient had clawing of great toe, When the ankle was passively plantar flexed, the deformity became fully flexible and completely corrected, but when passively dorsiflexed clawing became more prominent and fixed (rigid) due to the fixed length phenomenon of the long flexors. Patient had fracture shaft of tibia for which open reduction and internal fixation with intramedullary interlocking nail was done 12 months back.patient underwent FHL lengthening by Z plasty through retromalleolar approach and had full correction of deformity RESULTS Patient had full correction of all clawed toes. Follow-up at 12 months, patient reported relief from pain, ease of shoe-fitting and subjective improvement of gait. There was no recurrence of the deformity. CONCLUSION Dynamic claw toe deformity is rarely diagnosed disease. Surgical treatment is better than conservative treatment in correcting the deformity. Recurrence following surgical correction is very rare.