Hammer Toes Causes And Cures
Overview
hammertoe, also called hammer toe, deformity of the second, third, or fourth toe in which the toe is bent downward at the middle joint (the proximal interphalangeal [PIP] joint), such that the overall shape of the toe resembles a hammer. Most cases of hammertoe involve the second toe, and often only one or two toes are affected. In rare cases when all the toes are involved, a thorough neurological assessment is necessary to evaluate for underlying nerve or spinal cord problems.
Causes
Footwear can contribute significantly to the development of hammertoes. Shoes that are too small force your toes into a curled position. Over time, your toe tendons adjust to this positioning, causing your toe or toes to hold a hammered shape. Athletes may be especially susceptible, because of the increased forces on the toes from shoes that are too small or tight. Heel elevation in footwear is also problematic, as it causes your toes to be pushed into the shoe?s toe box. Heel elevation additionally contributes to muscle imbalance. A common example of this is when your Achilles tendon-the tendon at the back of your leg that attaches your calf muscles to your heel bone-is too tight, causing the tendons on the top of your foot that attach to your toes to work too hard and hold your toes in an unnatural, elevated position.
Symptoms
Hammer toe is often distinguished by a toe stuck in an upside-down ?V? position, and common symptoms include corns on the top of your toe joint. Pain at the top of a bent toe when you put on your shoes. Pain when moving a toe joint. Pain on the ball of your foot under the bent toe. Corns developing on the top of the toe joint. It is advisable to seek medical advice if your feet hurt on a regular basis. It is imperative to act fast and seek the care of a podiatrist or foot surgeon. By acting quickly, you can prevent your problem from getting worse.
Diagnosis
First push up on the bottom of the metatarsal head associated with the affected toe and see if the toe straightens out. If it does, then an orthotic could correct the problem, usually with a metatarsal pad. If the toe does not straighten out when the metatarsal head is pushed up, then that indicates that contracture in the capsule and ligaments (capsule contracts because the joint was in the wrong position for too long) of the MTP joint has set in and surgery is required. Orthotics are generally required post-surgically.
Non Surgical Treatment
There is a variety of treatment options for hammertoe. The treatment your foot and ankle surgeon selects will depend upon the severity of your hammertoe and other factors. A number of non-surgical measures can be undertaken. Padding corns and calluses. Your foot and ankle surgeon can provide or prescribe pads designed to shield corns from irritation. If you want to try over-the-counter pads, avoid the medicated types. Medicated pads are generally not recommended because they may contain a small amount of acid that can be harmful. Consult your surgeon about this option. Changes in shoewear. Avoid shoes with pointed toes, shoes that are too short, or shoes with high heels, conditions that can force your toe against the front of the shoe. Instead, choose comfortable shoes with a deep, roomy toe box and heels no higher than two inches. Orthotic devices. A custom orthotic device placed in your shoe may help control the muscle/tendon imbalance. Injection therapy. Corticosteroid injections are sometimes used to ease pain and inflammation caused by hammertoe. Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation. Splinting/strapping. Splints or small straps may be applied by the surgeon to realign the bent toe.
Surgical Treatment
Surgery is the approach that is often necessary to correct hammertoe that fails to respond to nonsurgical management. Surgery is appropriate when the muscles and tendons involved in a hammertoe problem have become so tight that the joints are rigid, misaligned and unmovable. There are a number of surgical techniques for dealing with the complex range of joint, bone, muscle, tendon and ligament abnormalities that define each hammertoe's make-up. To correct a hammertoe deformity, the Hammer toe surgeon's goal is to restore the normal alignment of the toe joint, relieving the pressure that led to the hammertoe's development (this should also relieve the pain, as well). To do this, he or she may remove part of the boney structure that creates a prominence at the top of the joint. Tighten or loosen the muscles, tendons and ligaments around the toe joints. Realign the toe bones by cutting one or more and shifting their position, realigning muscles, tendons and ligaments accordingly. Use screws, wires or plates to hold the joint surfaces together until they heal. Reconstruct a badly damaged joint or replace it with an artificial implant.
Hammer Toe Decreasing Surgery
Overview
A Hammer toes occurs when the joint of the toes curl down. The reason they curl abnormally is due to a muscle imbalance which results in the tendons becoming unnaturally tight. They are due to Heredity, improper shoes, and Arthritis. There are two types of hammer toes, flexible or rigid. These classification are based on the mobility of the toe joints. A flexible hammer toe is one with a flexible toe joint that allows it to be straightend with your finger. In time a flexible joint may turn into a rigid hammer toe. Normally flexible hammer toes are much less painful than rigid hammer toes. A rigid hammer toe is one with a rigid toe joint, one that is not moveable with your finger. These rigid toe joints can be very painful and limit the ability to move.
Causes
Hammertoe has three main culprits: tight shoes, trauma, and nerve injuries or disorders. When toes are crowded in shoes that are too tight and narrow, they are unable to rest flat, and this curled toe position may become permanent even when you aren't wearing shoes due to the tendons of the toe permanently tightening. When the tendons are held in one position for too long, the muscles tighten and eventually become unable to stretch back out. A similar situation may result when tendons are injured due to trauma, such as a stubbed, jammed, or broken toe.
Symptoms
Hammertoe and mallet toe feature an abnormal bend in the joints of one or more of your toes. Moving the affected toe may be difficult or painful. Corns and calluses can result from the toe rubbing against the inside of your shoes. See your doctor if you have persistent foot pain that affects your ability to walk properly.
Diagnosis
Hammer toes may be easily detected through observation. The malformation of the person's toes begin as mild distortions, yet may worsen over time - especially if the factors causing the hammer toes are not eased or removed. If the condition is paid attention to early enough, the person's toes may not be permanently damaged and may be treated without having to receive surgical intervention. If the person's toes remain untreated for too long, however the muscles within the toes might stiffen even more and will require invasive procedures to correct the deformity.
Non Surgical Treatment
If your hammertoe problem is diagnosed as flexible hammertoe, there are a number of nonsurgical treatments that may be able to straighten out your toe or toes and return them to their proper alignment. Padding and Taping. Your physician may pad the boney top-part of your hammertoe as Hammer toe a means of relieving pain, and may tape your toes as a way to change their position, correct the muscle imbalance and relieve the pressure that led to the hammertoe's development. Medication. Anti-inflammatory drugs such as aspirin and ibuprofen can help deal with inflammation, swelling and pain caused by your hammertoe. Cortisone injections may be prescribed for the same purpose. If your hammertoe is a consequence of arthritis, your physician may prescribe medications for that.
Surgical Treatment
If conservative measures fail to provide relief, or if your hammertoe is in advanced stages with rigidity and a significant amount of pain, surgery may be required. Some patients also require surgery if they have open sores or wounds related to their hammertoe. For patients who also suffer from bunions, a combined procedure may be appropriate, addressing both conditions within the same surgery. Recovery time will vary from patient to patient, depending on the extent of the surgical repair and other conditions that may also be present.
