MOBILE CLAW TOE SYNDROME (CHECKREIN DEFORMITY): a clinical case

Introduction. The syndrome of mobile claw toes or, as it is commonly called in the English-language scientific literature, checkrein deformity is a rare dynamic deformity of toes that develops secondary to any traumatic factor at the level of the ankle joint and foot. A special aspect of the clinical example presented is that the pathology developed without any direct impact on the above-mentioned anatomical areas. We have not found any references to or descriptions of such a clinical observation in the literature available. The aim of the publication was to demonstrate the clinical observation of a patient with the spontaneously developed syndrome of mobile claw toes. Materials and Methods. The article presents the outcomes of the surgical treatment of this pathology in a 52-year-old female patient and evaluates the resulting functional changes using pedobarometric and stabilometric tests. Results and Discussion. A 52-year-old female patient, four months after the planned surgical intervention (augmentation mammoplasty), drew attention to the restriction of movements in the I and II metatarsophalangeal joints in a certain left foot position, which progressed and made it difficult to walk and stand on tiptoes. No preceding injury facts have been established. Conservative treatment did not produce the desired effect. Surgical intervention was performed, which consisted in the release and Z-shaped elongation of the tendons of the long flexor of the first finger and the long flexor of the toes. After the surgery, the operated foot was immobilized for 6 weeks with a posterior plaster splint at an angle of 90 degrees. During the treatment, there were no abnormalities in the patient’s condition or in clinical and laboratory parameters. The stitches were removed on the fourteenth day. Six weeks after the operation, immobilization was discontinued, and walking was allowed with a gradual loading increase. The surgical intervention resulted in the relief of manifestations of the claw toes syndrome and the restoration of foot support, which allowed the patient to return to her usual lifestyle without any restrictions, and the objective criterion of effectiveness was the improvement of basic pedobarometric and stabilometric indicators. Conclusions. The patient treatment outcome obtained regarding the syndrome of mobile claw toes allows us to conclude that surgical treatment is acceptable and encourages further search for the causes of this syndrome and possible options of preventing it.