Orthopädie und Muskulatur: Aktuelle Forschung
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Post Traumatic Clawing of Foot

Babak Siavashi and Mohammad Reza Golbakhsh

Introduction: Clawing of toes of foot are usually seen in neuromuscular disorders , but in some instances, after trauma to leg ,which may be accompanied with fracture or not, after healing of fracture or soft tissue injuries, clawing deformity of foot may be appeared. We try to determine the cause of it and the most appropriate treatment for it.

Materials and methods: We study about 106 patients in sina hospital (Tehran, Iran) from 2000 to 2007. After confirmation of ethical approval, they enter our study. All of them were our original patients whom for their first trauma were referred to emergency room of our hospital. 101 of them had fracture of leg but in 5 cases there were no fracture of leg. In the follow up visits of them, we see there is clawing of foot so we examine them for sensory and motor function and take radiography and electromyography (EMG) of lower extremity. We do tenotomy of flexors of their toes and remove callosities if necessary.

Findings: There were no sensory or motor deficit in their traumatized lower extremities and also there were no abnormality in their EMG. In the X rays of them, there were no obvious or huge callus mass. In the radiography of their foot, there were no fracture of foot bones and also no abnormality of their toes like malunion or destruction of small joints of their feet.

Conclusion and discussion: We try to rule out some causes of clawing of foot .There were no checkrein effect of fracture callus and in EMG, there were no nerve injury and there were no bony abnormality in X rays. They have only unilateral problem and their clawing begins after trauma so neuromuscular diseases can be ruled out.

We think a fibrotic event after crush injury to calf muscles can produce this deformity.