Hammer Toe Operations

HammertoeOverview

The term, Hammer toe, is commonly used as a general classification for any condition where the toe muscle weakens, causing digital contracture, and resulting in deformity, a digital contracture like this can actually be a hammertoe, claw toe or mallet toe, depending on which joints in the toe are contracted. Clawtoes are bent at the middle and end joints, while hammertoes are bent at the middle joint only. When it?s mallet toe, the joint at the end of the toe buckles. The skin near the toenail tip develops a painful corn that can eventually result in an ulcer. Doctors further categorize all forms of hammertoe based on whether the affected toe is flexible, semi-rigid or rigid. The more rigid the toe, the more pain it will cause.

Causes

The most common cause of hammertoe is a muscle/tendon imbalance. This imbalance, which leads to a bending of the toe, results from mechanical (structural) changes in the foot that occur over time in some people. Hammertoes may be aggravated by shoes that don?t fit properly. A hammertoe may result if a toe is too long and is forced into a cramped position when a tight shoe is worn. Occasionally, hammertoe is the result of an earlier trauma to the hammertoe toe. In some people, hammertoes are inherited.

Hammer ToeSymptoms

Symptoms may include pain in the affected toe or toes when you wear shoes, making it hard or painful to walk. A corn or callus on the top of the joint caused by rubbing against the shoe. Swelling and redness of the skin over the joint. Trouble finding comfortable shoes.

Diagnosis

A hammertoe is usually diagnosed with a physical inspection of your toe. Imaging tests, such as X-rays, may be ordered if you have had a bone, muscle, or ligament injury in your toe.

Non Surgical Treatment

You should seek medical advice if you have a hammer toe. Here are some things you can do in the meantime. None of these things will cure the hammer toe, but they may relieve the pain and discomfort. Only wear shoes that are high and broad across the toes. There should be at least 1.5 cm of space between your longest toe and the tip of the shoe. Keep in mind that this could be either your big toe or your second toe. Don't wear heels higher than 5 cm. Wear the appropriate shoe for the activity you are doing. You can buy non-medicated hammer toe pads. They fit around the pointy top of the toe joint and help relieve painful pressure. Gently massaging the toe may help relieve pain. Put ice packs wrapped in cloth on the hammer toe to reduce painful swelling.

Surgical Treatment

For the surgical correction of a rigid hammertoe, the surgical procedure consists of removing the 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.

HammertoePrevention

Few people realize that their feet grow over the years: actually, the heel stays the same, but the front of the foot becomes wider and longer. The result, most women wear shoes that fit at the heel but are much too narrow in the front. Buy shoes that fit the longer foot. For two out of three people, one foot is significantly bigger than the other. Have both feet measured whenever you buy shoes. Have your feet measured while you're standing, and buy shoes that fit the larger foot. Shop at the end of the day, when foot swelling is greatest. No shoe should feel tight. Don't go by numbers. You may think of yourself as a size 8B, but size varies from shoe to shoe. There is no standardization, so pick the shoes that fit best. Limit high-heel use. These shoes increase pressure on the front of the foot by at least 50 percent, so wear them only for special occasions. Flat shoes are more comfortable than high heels, but they, too, can be hard on your feet, especially if they are thin-soled. Change your shoes. If your shoes are too short or too narrow, get another pair. This is especially important for children going through periods of rapid growth. The toe area should be high enough so that it doesn't rub against the top of your toes-especially if hammer toes have started to develop.

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