Orthopaedic problems in fingers and toes.

 “A mans best friends are his ten fingers”
by Robert Collyer (1823-1912)

What is Trigger finger?
This condition of Trigger Finger causes progressive deformity and curling of the fingers.

It can occur in one or more fingers. The tendons in your fingers are like ropes that attach to the ends of your fingers. When your forearm muscle contracts, the tendons pull the fingers into a fist.

The tendons run part of their course through a sheath called the flexor tendon sheath. In patients who have a trigger finger, this mechanism of movement can fail. The tendon develops a small swelling at its base which stops the tendon sliding smoothly within the tendon sheath.

At first it slows down the sliding movement and the tendon sticks within the sheath, under tension the tendon breaks free causing a snapping sound at the tendon frees itself from the sheath. Finally the fingers get stuck in a flexed position causing deformity and impeding some hand function.   

Treatment: The definitive treatment is a simple surgery carried out as a dasy case under local anaesthetic. The surgeon frees the tendon and makes more room for it to move freely.The aim of this surgery is to restore normal function and movement.


What is a Bunion? 
Even though bunions are a common foot deformity, there are misconceptions about them. Many people may unnecessarily suffer the pain of bunions for years before seeking treatment. A bunion (also referred to as hallux valgus) is often described as a bump on the side of the big toe.

The big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment – producing the bunion’s “bump.” This is caused by a developing deformity of the metatarsophalangeal joint, the joint at the base of our big toe. The big toe is forced to lean inwards towards the second toe.


The lump becomes more pronounced and with pressure from our shoes becomes inflamed and very painful.

A bunionette is the same problem but occurs on the other side of the foot at the base of the little toe. The symptoms and treatment are essentially the same.

Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump deformity, which becomes increasingly prominent. This can lead to deformity of the second too also.

For ladies, finding suitable comfortable footwear can become impossible.  

Treatment: The treatment after toe splints and comfortable footwear and painkillers have failed is a simple corrective surgery.

The operation is routine and can be performed under a spinal anaesthetic. The surgeon makes a small incision and removes a small wedge of bone in order to reshape and straighten the joint and leave it looking more normal. The goal of the operation is to relieve the pain and to reduce the deformity and allow the use of normal shoes.

What are Hammer toes?
This is a very common condition.

A hammer toe is a toe that's curled due to a deformity in the middle joint of a toe.

Mallet toe is similar, but affects the upper (proximal interphalangeal) joint of a toe.

Both hammertoe and mallet toe are commonly caused by shoes that are too tight or short in the front or shoes that have high heels.

Under these conditions, your toes may be forced against the front of your shoes, resulting in an unnatural bending of your toe and a hammer-like or claw-like appearance.

The deformity can be gradual and eventually becomes very painful as normal footwear causes pressure and rubbing on the prominent joint of the hammer toes making normal footwear impossible.

Treatment: After conservative methods have failed the definitive solution is a simple operation carried out under spinal anaesthetic. The surgeon reshapes the joints to restore their normal position .The operation is aimed to relieve the pain and allow more normal footwear.
Morton's neuroma

(also known as Morton's metatarsalgia or Morton's neuralgia, is a benign neuroma (small growth) on an intermetatarsal plantar nerve, most commonly of the third and fourth intermetatarsal spaces.

 The problem is characterised by numbness and sometimes intense shooting pain (like electricity) shooting into the toes. The pain is normally more intense whilst standing or walking.

It is more common in women and is thought to be due partly to poor footwear.

Here in Spain the floors are stone and the only protection offered to the foot structures are our shoes. Some shoes have very thin hard soles and offer little or no protection to the feet.

Treatment: Conservative treatment is highly recommended , your doctor may send you to the Podologist to be fitted with insoles to protect the neuroma and reduce the pain.