Overview
A
Hammer toe is a term used to describe a crooked, deviated, or contracted
toe. Although the condition usually stems from muscle imbalance, it is often aggravated by poor-fitting shoes or socks that cramp the toes. Over a period of years, the tendons that move the
toe up and down begin to pull the
toe with unequal tension, and the
toe then begins to buckle or become contracted, causing an abnormal ?v?-shaped bending of the little toes. Patients with this condition often experience pain, swelling, redness and stiffness in the affected toes.
Causes
Shoes that narrow toward the
toe may make your forefoot look smaller. But they also push the smaller toes into a flexed (bent) position. The toes rub against the shoe, leading to the formation of corns and calluses, which further aggravate the condition. A higher heel forces the foot down and squishes the toes against the shoe, increasing the pressure and the bend in the
toe. Eventually, the
toe muscles become unable to straighten the
toe, even when there is no confining shoe.
Symptoms
The most obvious symptom of hammer, claw or mallet
toe is the abnormal
toe position. This is usually combined with pain: the abnormal foot position leads to excessive friction on the
toe as it rubs against any footwear which can be extremely
hammertoe painful. Corns & Calluses: repeated friction can result in the formation of a foot corn or callus on top of the toes. Stiffness, the joints become increasingly stiff. In the early stages, the toes can usually be straightened out passively using your hands, but if allowed to progress, the stiffness may be permanent.
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
If the affected
toe is still flexible, you may be able to treat it by taping or splinting the
toe to hold it straight. Your family doctor can show you how to do this. You may also try corrective footwear, corn pads and other devices to reduce pain. You may need to do certain exercises to keep your
toe joints flexible. For example, you may need to move and stretch your
toe gently with your hands. You can also exercise by picking things up with your toes. Small or soft objects, such as marbles or towels, work best. If your hammer
toe becomes painful, you may need to apply an ice pack several times a day. This can help relieve the soreness and swelling. Nonsteroidal anti-inflammatory medicines (also called NSAIDs), such as ibuprofen (two brand names: Advil, Motrin) or naproxen (one brand name: Aleve), may be helpful. If your pain and swelling are severe, your doctor may need to give you a steroid injection in the
toe joint.
Surgical Treatment
If conservative treatments fail and your symptoms persist, the doctor may recommend a surgical option to straighten the
toe. The procedures used vary greatly, depending upon the reasons for the hammertoe. There are a number of different operations to correct hammertoes, the most common ones involve Soft tissue corrections such as tendon transfers, tendon lengthening, and joint
capsule repairs. Digital arthroplasty involves removal of bone from the bent joint to allow the
toe to straighten. The temporary use of pins or K-wires may be necessary to keep the
toe straight during the healing period. Joint implants are sometimes used to allow for a better range of motion in the
toe following surgery. Digital arthrodesis involves the removal of bone from the bent joint and fusing the
toe in a straight position. If the corn is due to a bone spur, the most common procedure used is an exostectomy, in which surgically removing it or filing it down removes the bone spur. Because of the possible complications involved with any surgery, one should be sure to understand the risks that may be involved with surgery to correct hammertoes and remove bone spurs.
Prevention
wear sensible shoes. Here are some tips. Most people have one foot that's bigger than the other. Fit your shoes to the bigger foot. Buy your shoes at the end of the day as your feet
tend to swell a bit and you will get a better sense of fit. When you buy your shoes, wear the sock that you will be using when wearing that shoe - wear a sports sock when buyingtrainers, for example. As you get older, your feet get bigger. Get your feet measured every time you buy shoes. Don't go by shoe sizes. Shoe sizes vary among manufacturers; a shoe is the right size only when it fits comfortably. The ball of your foot should fit into the widest part of the shoe. A shoe should be sturdy so that it only bends in the ball of the foot, exactly where your big toes bend. Any shoe that can be bent anywhere along the
sole or twisted side to side is generally too flimsy. There should be at least 1.5 cm between the tip of your longest
toe and the front of the shoe. Never buy shoes that feel tight and expect them to stretch with wearing. If you have prominent areas on your feet such as hammer toes and bunions, avoid shoes with a lot of stitching or multiple pieces of fabric, as these stitched areas
tend not to stretch to accommodate various
toe deformities. Your shoes shouldn't ride up and down on your heel as you walk. The higher the heel, the less safe the shoe. Check children's shoes regularly.