Selective lengthening of the proximal flexor tendon in the management of acquired claw toes

We report the management of the acquired claw-toe deformity in ten adults. Each patient developed a varying number of claw toes at a mean interval of six months after the time of injury. There was clinical evidence of an acut e compartment syndrome in one case. The clawing occurred at the start of he el-rise in the stance phase of gait. At this stage the patients complained of increasing pain and pressure on the tips of the toes. The deformities were corrected by lengthening flexor hallucis longus and fl exor digitorum longus alone or in combination. The presence of variable int ertendinous digitations between the tendons of flexor hallucis longus and f lexor digitorum longus means that in some cases release of flexor hallucis longus alone may correct clawing of lesser toes.