Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a chief complaint of a fixed flexion deformity of the right second toe. Reports progressive pain at the dorsal aspect of the proximal interphalangeal (PIP) joint, exacerbated by closed-toe footwear. Denies trauma, numbness, or paresthesia. Symptoms are chronic and interfere with daily ambulation.
Clinical Examination Findings
Right foot examination reveals a rigid hammertoe deformity of the second digit. Dorsal PIP joint prominence noted with overlying hyperkeratotic lesion (corn). MTP joint is stable with no evidence of subluxation. Passive range of motion at the PIP joint is restricted. Neurovascular status intact; distal pulses palpable, capillary refill <2 seconds.
Treatment Protocol
Conservative management initiated: dispensed accommodative orthotics and toe crest pad to offload the dorsal PIP joint. Advised on wide-toe box footwear. Discussed potential for surgical intervention (PIP joint arthroplasty or fusion) if symptoms persist. Patient instructed on daily foot hygiene and monitoring for skin breakdown.