Hammer Toe Causes

HammertoeOverview

A hammertoe is a toe that is bent because of a muscle imbalance around the toe joints. The imbalance causes the toe to bend at one or more joints, pushing the middle of the toe upward in a claw-like position. If you notice such changes, it is important to seek proper treatment. Hammer toes never get better without some type of intervention and the sooner it is treated, the better the outcome.

Causes

The incorrect position of the person's toes inside of their shoes also causes the formation of calluses or corns on the surfaces of their toes which are constantly bent as they are wearing inappropriate shoes because the surfaces are consistently rubbing against the hard materials of the interior of the shoes causing regular friction.

Hammer ToeSymptoms

The most obvious sign of hammertoes are bent toes, 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.

Diagnosis

The exam may reveal a toe in which the near bone of the toe (proximal phalanx) is angled upward and the middle bone of the toe points in the opposite direction (plantar flexed). Toes may appear crooked or rotated. The involved joint may be painful when moved, or stiff. There may be areas of thickened skin (corns or calluses) on top of or between the toes, a callus may also be observed at the tip of the affected toe beneath the toenail. An attempt to passively correct the deformity will help elucidate the best treatment option as the examiner determines whether the toe is still flexible or not. It is advisable to assess palpable pulses, since their presence is associated with a good prognosis for healing after surgery. X-rays will demonstrate the contractures of the involved joints, as well as possible arthritic changes and bone enlargements (exostoses, spurs). X-rays of the involved foot are usually performed in a weight-bearing position.

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

Treatment hammertoes of a severe hammertoe that has become rigid includes surgery. What is done during the surgery depends on how misshapen and inflexible the toe is. The surgeon may make a cut over your toe and release the tendon by cutting the tendon away from the bone. The surgeon may remove a small piece of bone from the toe. The surgeon may realign the tendons to reposition your toe or fasten the bones with pins. Sometimes the surgeon may have to join the bones in the toe. In this case, you will no longer be able to bend the toe, but the toe will be flat.

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