Hammertoe
Hammertoe is an abnormal contracture (bending) of the 2nd, 3rd, 4th, or 5th toe of the foot. The contracture can occur at one or multiple joints of a single toe. The contracture can be flexible, or rigid. Issues associated with these contractures include pressure at certain sites, causing pain when wearing shoes, and when walking. Most hammertoes are progressive in nature unless intervention is applied.
Causes:
The cause of hammertoes is muscle or tendon imbalance. This imbalance leads to unequal pull of the toe in a certain direction. The cause of the imbalance can be neurological or structural. This can be inherited, caused by trauma, or any underlying neurological diseases.
symptoms:
Improper shoe wear can also aggravate the deformity. Patients often complain of pain or irritation from the shoes. Corns and callus can build up on the toes, in between the toes, and ball of the foot. If the irritation is serious, inflammation, redness, or ulcerations might occur.
Diagnosis:
It is important to understand the underlying cause of the hammertoe deformity, and not just accept the diagnosis as is. This requires a thorough history, and comprehensive physical exam. To assess the degree of osseous (bone) deformity, X-rays can be acquired.
Hammertoes are progressive, as they do not improve over time. Early diagnosis and treatment of the hammertoe is important to avoid worsening condition.
Treatments:
Conservative treatments for hammertoe deformities involve mainly symptom relief and slowing the progression of the condition. This involves the following:
If symptom relief is not able to be achieved through conservative treatments, or if the deformity is severe, then surgery can be considered. The procedure for the correction will depend on the extent of the deformity, number of toes involved, age, activity level and other factors.
Hammertoe is an abnormal contracture (bending) of the 2nd, 3rd, 4th, or 5th toe of the foot. The contracture can occur at one or multiple joints of a single toe. The contracture can be flexible, or rigid. Issues associated with these contractures include pressure at certain sites, causing pain when wearing shoes, and when walking. Most hammertoes are progressive in nature unless intervention is applied.
Causes:
The cause of hammertoes is muscle or tendon imbalance. This imbalance leads to unequal pull of the toe in a certain direction. The cause of the imbalance can be neurological or structural. This can be inherited, caused by trauma, or any underlying neurological diseases.
symptoms:
Improper shoe wear can also aggravate the deformity. Patients often complain of pain or irritation from the shoes. Corns and callus can build up on the toes, in between the toes, and ball of the foot. If the irritation is serious, inflammation, redness, or ulcerations might occur.
Diagnosis:
It is important to understand the underlying cause of the hammertoe deformity, and not just accept the diagnosis as is. This requires a thorough history, and comprehensive physical exam. To assess the degree of osseous (bone) deformity, X-rays can be acquired.
Hammertoes are progressive, as they do not improve over time. Early diagnosis and treatment of the hammertoe is important to avoid worsening condition.
Treatments:
Conservative treatments for hammertoe deformities involve mainly symptom relief and slowing the progression of the condition. This involves the following:
- Padding corns and calluses. Your foot and ankle specialist 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 shoe wear. 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 toebox 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.
If symptom relief is not able to be achieved through conservative treatments, or if the deformity is severe, then surgery can be considered. The procedure for the correction will depend on the extent of the deformity, number of toes involved, age, activity level and other factors.