Overview
hammertoes is foot deformity that typically affects second, third or fourth toes. The condition is called hammertoe because of the unnatural position your toes form. Hammertoe causes your toe to bend upward at the middle joint in a way that looks similar to a hammer. While it may not be painful at first, this condition usually worsens with time and it becomes difficult to extend your toes. Sometimes, calluses or corns form in association with hammertoe.
Causes
Hammertoe and mallet toe have been linked to certain shoes. High-heeled shoes or footwear that's too tight in the toe box can crowd your toes into a space that's not large enough for them to lie flat. This curled toe position may eventually persist even when you're barefoot. Trauma. An injury in which you stub, jam or break a toe may make it more likely for that digit to develop hammertoe or mallet toe. Nerve injuries or disorders. Hammertoe and mallet toe are more common in people who have nerve damage in their feet, which often occurs with such medical problems as a stroke or diabetes.
Symptoms
For some people, a hammer toe is nothing more than an unsightly deformity that detracts from the appearance of the foot. However, discomfort may develop if a corn or callus develops on the end or top of hammertoes the toe. If pressure and friction continue on the end or top of the toe, a painful ulcer may develop. Discomfort or pain can lead to difficulty walking.
Diagnosis
The earlier a hammertoe is diagnosed, the better the prognosis and treatment options. Your doctor will be able to diagnose your hammertoe with a simple examination of the foot and your footwear. He or she may take an x-ray to check the severity of the condition. You may also be asked about your symptoms, your normal daily activities, and your medical and family history.
Non Surgical Treatment
Wear wide shoes with plenty of room in the toes and resilient soles. Avoid wearing shoes with pointed toes. Commercially available felt pads or cushions may ease pressure from the shoe on the toe. Toe caps (small, padded sleeves that fit around the tip of the toe) may relieve the pain of hammer toe. Do toe exercises, to help toe muscles become stronger and more flexible.
Arch supports or an orthotic shoe insert prescribed by your doctor or podiatrist may help to redistribute weight on the foot. These devices do not cure the problem but may ease the symptoms of either hammer toe or mallet toe.
Surgical Treatment
Probably the most frequent procedure performed is one called a Post or an Arthroplasty. In this case a small piece of bone is removed from the joint to straighten the toe. The toe is shortened somewhat, but there is still motion within the toe post-operatively. In other cases, an Arthrodesis is performed. This involves fusing the abnormally-contracted joint. The Taylor procedure fuses only the first joint in the toe, whereas the Lambrinudi procedure fuses both joints within the toe. Toes which have had these procedures are usually perfectly straight, but they take longer to heal and don't bend afterwards. A Hibbs procedure is a transfer of the toe's long extensor tendon to the top of the metatarsal bone. The idea of this procedure is to remove the deforming cause of the hammertoes (in this case, extensor substitution), but to preserve the tendon's function in dorsifexing the foot by reattaching it to the metatarsals. Fortunately, the Gotch (or Gotch and Kreuz) procedure--the removal of the base of the toe where it attaches to the foot, is done less frequently than in years past. The problem with this procedure is that it doesn't address the problem at the level of the deformity, and it causes the toe to become destabilized, often resulting in a toe that has contracted up and back onto the top of the foot. You can even have an Implant Arthroplasty procedure, where a small, false joint is inserted into place. There are several other procedures, as well.
Prevention
Have your feet properly measured, make sure that, while standing, there is a centimetre (? thumb) of space for your longest toe at the end of each shoe. Buy shoes that fit the longer foot. Shop at the end of the day, when foot swelling is greatest. Don't go by numbers, sizes vary by brand, so make certain your shoes are comfortable. Wear wide shoes with resilient soles, avoid shoes with pointed toes.
hammertoes is foot deformity that typically affects second, third or fourth toes. The condition is called hammertoe because of the unnatural position your toes form. Hammertoe causes your toe to bend upward at the middle joint in a way that looks similar to a hammer. While it may not be painful at first, this condition usually worsens with time and it becomes difficult to extend your toes. Sometimes, calluses or corns form in association with hammertoe.
Causes
Hammertoe and mallet toe have been linked to certain shoes. High-heeled shoes or footwear that's too tight in the toe box can crowd your toes into a space that's not large enough for them to lie flat. This curled toe position may eventually persist even when you're barefoot. Trauma. An injury in which you stub, jam or break a toe may make it more likely for that digit to develop hammertoe or mallet toe. Nerve injuries or disorders. Hammertoe and mallet toe are more common in people who have nerve damage in their feet, which often occurs with such medical problems as a stroke or diabetes.
Symptoms
For some people, a hammer toe is nothing more than an unsightly deformity that detracts from the appearance of the foot. However, discomfort may develop if a corn or callus develops on the end or top of hammertoes the toe. If pressure and friction continue on the end or top of the toe, a painful ulcer may develop. Discomfort or pain can lead to difficulty walking.
Diagnosis
The earlier a hammertoe is diagnosed, the better the prognosis and treatment options. Your doctor will be able to diagnose your hammertoe with a simple examination of the foot and your footwear. He or she may take an x-ray to check the severity of the condition. You may also be asked about your symptoms, your normal daily activities, and your medical and family history.
Non Surgical Treatment
Wear wide shoes with plenty of room in the toes and resilient soles. Avoid wearing shoes with pointed toes. Commercially available felt pads or cushions may ease pressure from the shoe on the toe. Toe caps (small, padded sleeves that fit around the tip of the toe) may relieve the pain of hammer toe. Do toe exercises, to help toe muscles become stronger and more flexible.
Arch supports or an orthotic shoe insert prescribed by your doctor or podiatrist may help to redistribute weight on the foot. These devices do not cure the problem but may ease the symptoms of either hammer toe or mallet toe.
Surgical Treatment
Probably the most frequent procedure performed is one called a Post or an Arthroplasty. In this case a small piece of bone is removed from the joint to straighten the toe. The toe is shortened somewhat, but there is still motion within the toe post-operatively. In other cases, an Arthrodesis is performed. This involves fusing the abnormally-contracted joint. The Taylor procedure fuses only the first joint in the toe, whereas the Lambrinudi procedure fuses both joints within the toe. Toes which have had these procedures are usually perfectly straight, but they take longer to heal and don't bend afterwards. A Hibbs procedure is a transfer of the toe's long extensor tendon to the top of the metatarsal bone. The idea of this procedure is to remove the deforming cause of the hammertoes (in this case, extensor substitution), but to preserve the tendon's function in dorsifexing the foot by reattaching it to the metatarsals. Fortunately, the Gotch (or Gotch and Kreuz) procedure--the removal of the base of the toe where it attaches to the foot, is done less frequently than in years past. The problem with this procedure is that it doesn't address the problem at the level of the deformity, and it causes the toe to become destabilized, often resulting in a toe that has contracted up and back onto the top of the foot. You can even have an Implant Arthroplasty procedure, where a small, false joint is inserted into place. There are several other procedures, as well.
Prevention
Have your feet properly measured, make sure that, while standing, there is a centimetre (? thumb) of space for your longest toe at the end of each shoe. Buy shoes that fit the longer foot. Shop at the end of the day, when foot swelling is greatest. Don't go by numbers, sizes vary by brand, so make certain your shoes are comfortable. Wear wide shoes with resilient soles, avoid shoes with pointed toes.