To evaluate the clinical results of acquired claw toe deformities that had been treated with proximal lengthening of the long toe flexor tendons.

Seventeen patients with a claw toe deformity due to contracture of the long flexor tendons were treated with proximal lengthening of the long toe flexor tendons from January 1993 to January 2003 and were followed up for at least 1 year. The average age at the time of the operation was 42 years and the average follow-up period was 34 months. Achilles tendon lengthening was also performed in 14 cases with an equinus deformity. At the final follow-up, a residual toe deformity, toe pain during walking, patient's satisfaction, and limitation of the shoe-wear were assessed.

At the final follow up, all cases showed a complete correction of a claw toe deformity, and did not have callosity at the toe tip or dorsal aspect of the toes. Toe pain during walking was found in 1 case, and a limitation of the shoe-wear was noted in 6 cases. At the final evaluation, 10 cases were graded as excellent, 6 good, and 1 fair. There was no recurrence of the claw toe deformity or limitation of the toe motion.

Proximal lengthening of the long toe flexor tendons is recommended for treating flexible claw toe deformities. The procedure produced excellent results regarding the deformity correction and pain relief.