On hallux flexus, claw toe, and pes cavus / by N. Davies-Colley.

  • Davies-Colley, John Neville Colley.
Date:
[1895?]
Catalogue details

Licence: Public Domain Mark

Credit: On hallux flexus, claw toe, and pes cavus / by N. Davies-Colley. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    such pressure is experienced. Perhaps this may be its greater projection forwards and the fact that it is more hemmed in on both sides than the other toes. The third and fourth toes, on account of the sloping outline of the front of the foot, are much freer to move outward than the second, and the other two toes being on the borders of the foot cannot be squeezed out in the same way by their neighbours. Moreover, some people are much more liable than others to the occurrence of this deformity, and it is not rare to see in young children a tendency of the second toe to become slightly bent and to project above the level of the other toes, which if especial care is not taken to allow of the proper lateral expansion of the tread during walking, will soon lead to the development of this deformity. When hammer-toe has once been established, certain in- flammatory changes are set up in the first phalangeal joint, and the contraction of the lateral ligament takes place which some look upon as the cause, but which I prefer to regard as the result, of the deformity. Whatever be the cause of claw toes, the results are very similar. They give rise to two sets of prominences upon the foot, the first beneath the heads of the metatarsal bones— the “ balls of the toes,” as they are called ; the second upon the dorsal aspect of the first phalangeal joints. Corns form over these prominences, and the pain to which they or the small burste which are developed beneath them give rise, is often so great as to make walking most difficult. It is in this way also that, as far as my experience goes, the pes cavus usually causes trouble. The muscles of the leg in this condition are often well developed, and the feet are pei'fectly efficient for progression ; but the lines of corns along the ball of the foot and over the claw toes become so exquisitely tender that the patient can only hobble about with great pain and difficulty. Treatvient.—In all cases of claw toe, except hammer toe, as soon as corns form and interfere with the patient’s power of walking, I believe that the best treatment is to bring down the first phalanges from their hyper-extended position, and to straighten out the first phalangeal joint. By these means the two prominences above mentioned are removed.
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