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Botox for the treatment of claw/hammer toes

Discussion in 'General Issues and Discussion Forum' started by Iñaki, Jul 4, 2012.

  1. Iñaki

    Iñaki Active Member

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    Hello everyone,

    Lately I have been hearing that botox can be used for the treatment of claw toes or hammer toes and i would like to know if there is any study regarding this matter.
    Does anyone know something about it?

    Many thanks
  2. Craig Payne

    Craig Payne Moderator

    There are no studies on it.

    There are several on its use for hyperihidrosis and heel pain, etc. See the other botox threads
  3. Iñaki

    Iñaki Active Member

    And even whitout studies is there anyone using this method?
  4. Lets think this one through...

    If there is structural changes at the interphalangeal joints, it won't work.
    If you inject into flexor digitorum brevis and or/ flexor digitorum longus and "block" them with botox, you're going to get a muscle imbalance (effectively an overpull) with the long and short digital extensors.
    If you knock out flexor digitorum brevis, you'll lose one of the MTPJ plantarflexors/ arch stiffness modulators= other muscles with this role have to work harder.... plantar fasciitis etc?
    If you block flexor digitorum longus, you'll lose one of the ankle plantarflexors/ MTPJ plantarflexors / arch stiffness modulators, other muscles with this role have to work harder..... achilles tendonopathy etc?
    You'll need repeat injections every 3-4 months.

    Any more...?
  5. blinda

    blinda MVP

    One of my pts had a course of botox therapy for limb dystonia, following stroke, at the Royal Leamington Spa Rehabilitation Hospital `botulinum toxin clinic`. There was slight improvement observed his fixed extended toes, but as Simon pointed out, the benefits were short lived and treatment was discontinued.

    You might find this of interest; Botulinum toxin for treatment of dystonia
  6. MischaK

    MischaK Active Member

    These studies may be of interest to you.:D

    Gaber, T. A. Z. K., Basu, B., Shakespeare, D., Singh, R., Salam, S., & McFarlane, J. (2011). Botulinum Toxin in the management of hitchhiker's toe. NeuroRehabilitation, 28(4), 395-399.

    Lee, J. H., Han, S. H., Ye, J. F., Lee, B. N., An, X., & Kwon, S. O. (2012). Effective zone of botulinum toxin a injections in hallux claw toe syndrome: An anatomical study. Muscle & Nerve, 45(2), 217-221. doi: 10.1002/mus.22263

    Lim, E. C. H., Ong, B. K. C., & Seet, R. C. S. (2006). Botulinum toxin-A injections for spastic toe clawing. Parkinsonism & Related Disorders, 12(1), 43-47. doi: 10.1016/j.parkreldis.2005.06.008

    Mitchell, P. D., Tisdall, M., & Zadeh, H. G. (2004). Selective botulinum toxin injection in the treatment of recurrent deformity following surgical correction of club foot. Acta Orthopaedica Scandinavica, 75(5), 630-633.

    Radovic, P. A., & Shah, E. (2008). Nonsurgical treatment for hallux abducto valgus with botulinum toxin A. Journal of the American Podiatric Medical Association, 98(1), 61-65.


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