Hammer Toe Operations

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HammertoeOverview

The 2nd toe is the most common digit to develop a Hammer toe deformity. Second toe hammer toes commonly result from an elongated 2nd metatarsal and from pressure due to an excessively abducted great toe (hallux valgus deformity) causing a bunion. Unusually long toes often develop hammer toe deformities. Painful corns often develop in hammer toe deformity, particularly of the 5th toe. Reactive adventitial bursas often develop beneath corns, which may become inflamed.

Causes

Hammer toe is often caused by wearing shoes that do not fit properly. If shoes are too small either in length or width, then the toes are held in a shortened position for long periods and the muscles eventually Hammer toe shorten and pull the toes into the bent position. Alternatively it can be caused by overactivity in the extensor digitorum dongus muscle (right) and a weakness in the counteracting muscle under the foot, such as flexor digitorum longus. Sometimes it can be a congenital condition, meaning it is present from birth. It is also more common in those with arthritis in the foot or diabetes.

HammertoeSymptoms

A toe (usually the second digit, next to the big toe) bent at the middle joint and clenched into a painful, clawlike position. As the toe points downward, the middle joint may protrude upward. A toe with an end joint that curls under itself. Painful calluses or corns. Redness or a painful corn on top of the bent joint or at the tip of the affected toe, because of persistent rubbing against shoes Pain in the toes that interferes with walking, jogging, dancing, and other normal activities, possibly leading to gait changes.

Diagnosis

Some questions your doctor may ask of you include, when did you first begin having foot problems? How much pain are your feet or toes causing you? Where is the pain located? What, if anything, seems to improve your symptoms? What, if anything, appears to worsen your symptoms? What kind of shoes do you normally wear? Your doctor can diagnose hammertoe or mallet toe by examining your foot. Your doctor may also order X-rays to further evaluate the bones and joints of your feet and toes.

Non Surgical Treatment

Hammertoes that are not painful (asymptomatic) and still flexible may not require treatment. In mild cases, open-toed, low-heeled, or wider shoes and foam or moleskin pads can provide symptomatic relief by reducing pressure. Taping (strapping) the affected toe can help to reduce deformity and pain. Physical therapy to instruct patients in exercises that passively stretch tight structures and strengthen weak foot intrinsic muscles is also helpful with mild cases. Periodic trimming (debridement) of corns (clavi, helomata) by a podiatrist can provide temporary relief. Corticosteroid injections are often very effective in reducing pain.

Surgical Treatment

If you have a severe case of hammer toe or if the affected toe is no longer flexible, you may need surgery to straighten your toe joint. Surgery requires only a local anesthetic (numbing medicine for the affected area) and is usually an outpatient procedure. This means you don?t have to stay in the hospital for the surgery.

HammertoePrevention

The number-one hammertoe prevention tip is to wear properly fitting shoes. If your shoes feel too snug, go to your local shoe store and have the length and width of your feet measured. If you wear high heels, keep the heel height to 2 inches or less. Wearing shoes with high heels increases the pressure on your toes and causes them to bend. It can also cause the formation of corns and a high arch.
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