HammerToes

HammertoeOverview

Hammer toes are usually not a serious condition, but can become painful as the bent joint rubs against the inside of the shoe, causing irritation, corns, or calluses on the top of the middle joint or the tip of the toe. A Hammer toe may also cause occasional shooting pains throughout the toes or elsewhere in the foot. A hammertoe has a kink or contracture in its second joint--called the proximal interphalangeal joint--that causes the toe to bend upward in the middle, giving it a hammer-like appearance. The raised part of the toe often rubs on shoes, leading to the formation of corns or calluses. Usually hammertoe affects the smaller toes, causing pain and interfering with the ability to walk normally.

Causes

Hammer toe is most often caused by wearing compressive shoes. It might also be caused by the pressure from a bunion. A bunion is a corn on the top of a toe and a callus on the sole of the foot develop which makes walking painful. A high foot arch may also develop.

HammertoeSymptoms

The most obvious symptom of hammertoe is the bent, hammer-like or claw-like appearance of one or more of your toes. Typically, the proximal joint of a toe will be bending upward and the distal joint will be bending downward. In some cases, both joints may bend downward, causing the toes to curl under the foot. In the variation of mallet toe, only the distal joint bends downward. Other symptoms may include Pain and stiffness during movement of the toe, Painful corns on the tops of the toe or toes from rubbing against the top of the shoe's toe box, Painful calluses on the bottoms of the toe or toes, Pain on the bottom of the ball of the foot, Redness and swelling at the joints. If you have any of these symptoms, especially the hammer shape, pain or stiffness in a toe or toes, you should consider consulting your physician. Even if you're not significantly bothered by some of these symptoms, the severity of a hammertoe can become worse over time and should be treated as soon as possible. Up to a point hammertoes can be treated without surgery and should be taken care of before they pass that point. After that, surgery may be the only solution.

Diagnosis

Hammertoes are progressive, they don?t go away by themselves and usually they will get worse over time. However, not all cases are alike, some hammertoes progress more rapidly than others. Once your foot and ankle surgeon has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.

Non Surgical Treatment

Treatment options for a hammertoe are based on the severity of the condition. A hammertoe caused by inappropriate footwear can be corrected by wearing properly fitting shoes. If a high arch caused the condition, wearing toe pads or insoles in your shoes can help. These pads work by shifting your toe?s position, which relieves pain and corrects the appearance of your toe.

Surgical Treatment

For the surgical correction of a rigid hammertoe, the surgical procedure consists of removing the hammertoes damaged skin where the corn is located. Then a small section of bone is removed at the level of the rigid joint. The sutures remain in place for approximately ten days. During this period of time it is important to keep the area dry. Most surgeons prefer to leave the bandage in place until the patient's follow-up visit, so there is no need for the patient to change the bandages at home. The patient is returned to a stiff-soled walking shoe in about two weeks. It is important to try and stay off the foot as much as possible during this time. Excessive swelling of the toe is the most common patient complaint. In severe cases of hammertoe deformity a pin may be required to hold the toe in place and the surgeon may elect to fuse the bones in the toe. This requires several weeks of recovery.

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