My Fifth Toe Is Constricted!

Ainhum is a painful constriction of the base of the fifth toe, which is typically followed by autoamputation several years later. It largely affects black people living in West Africa, South America, and India. In Nigeria, it is so common it affects 1.7 in every 1,000. In tropic and subtropic zones, it affects between 0.015 and 2.0 percent of the population. The average age for the patient is 38, but affects those between 20 and 50 years old. The youngest ever affected was seven years of age. It is more common in men than women and is often familial.
In the African Yorub language, ainhum means "to saw or file" and in Brazilian dialects it means "fissure". The exact cause of ainhum is unknown and it not caused by infection, parasites, fungi, bacteria, virus, and is not related to an injury. Doctors speculate that walking barefoot as a child may bring on this deformity, but ainhum also occurs in patients who have never walked barefoot. Since ainhum has been reported to occur within families, race and genetics may be one component. It has been linked to inadequate posterior tibial artery circulation and the absence of a plantar arch.
What is known as a groove will form on the lower and internal side of the base of the fifth toe, usually along the plantar digital fold. Over time, the groove will become deeper and more circular. The rate at which this condition spread varies, and may progress to a full circle within a few months or take many years. In roughly 75 percent of patients both feet are affected, though not necessarily to the same degree. There has been no case where it begins on another toe, but occasionally the third or fourth toes are affected. The distal part of the toe will begin to swell due to lymphatic edema distal and look like a small potato. When the groove deepens, compression of nerves, tendons, and vessels occurs and the bone will be absorbed by pressure. The toe's connection to the foot will become increasingly slender and will spontaneously fall off without bleeding. It usually takes about five years for autoamputation to occur.
About 78 percent of those affected have pain, which increases with gradual pressure
Little can be done for those with ainhum. Incisions across the groove have proven ineffective. Excision of the groove followed by a z-plasty can relieve pain and prevent amputation in Grade 1 and Grade 2 lesions. For Grade 3 lesions disarticulating the metatarsophalangeal joint has helped. Corticosteroid injections are sometimes helpful.
To prevent ainhum, avoid walking barefoot.
Reference: Wikipedia
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
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