Hammer Toe Surgery Treatment

HammertoeOverview

The term hammertoes describes three unique contracture deformities of the toes. The deformities differ by the location of contracture in each joint of the toe. The three deformities include hammer toe, claw toe and mallet toe. Hammer toes may be flexible or rigid. Hammer toes are most common on the lesser toes (2-5) and may affect one or more toes simultaneously. Hallux malleus is the term used to described a hammer toe of the great toe. Hallux malleus is often found as an isolated foot problem. Hammer toes are found equally in men and women. The onset of hammer toes is between the ages of 30 and 80 years of age.

Causes

Hereditary and shoe gear are probably the most likely reasons to develop a hammer toe. Tight pointy shoes may cause a hammer toes. High heels also can cause hammer toes. A deformed toe often develops over time, and certain types of feet may be predisposed. Some patients may develop a hammer toe or cross over toe (of the 2nd toe) due to a bunion of the big toe.

Hammer ToeSymptoms

Common symptoms of hammertoes include pain or irritation of the affected toe when wearing shoes. corns and calluses (a buildup of skin) on the toe, between two toes, or on the ball of the foot. Corns are caused by constant friction against the shoe. They may be soft or hard, depending upon their location. Inflammation, redness, or a burning sensation. Contracture of the toe. In more severe cases of hammertoe, open sores may form.

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 Hammer toes set in and surgery is required. Orthotics are generally required post-surgically.

Non Surgical Treatment

Your doctor may prescribe some toe exercises that you can do at home to stretch and strengthen the muscles. For example, you can gently stretch the toes manually. You can use your toes to pick things up off the floor. While you watch television or read, you can put a towel flat under your feet and use your toes to crumple it. Finally, your doctor may recommend that you use commercially available straps, cushions or nonmedicated corn pads to relieve symptoms. If you have diabetes, poor circulation or a lack of feeling in your feet, talk to your doctor before attempting any self-treatment.

Surgical Treatment

Joint resection procedures involves removing part of one of the two small joints of the toe directly underneath where the digit is crooked. The purpose is to make room for the toe to be re-positioned flat or straight. Because hammer toes become rigid or fixed with time, removing the joint becomes the only option when the knuckle is stiff. Its important to understand that this procedure does not involve the joint of the ball of the foot, rather the a small joint of the toe. Medical terminology for this procedure is called a proximal interphalangeal joint arthroplasty or a distal interphalangeal joint arthroplasty, with the latter involving the joint closer to the tip of the toe.

HammertoePrevention

Custom orthotics paired with a well made shoe can prevent the progression and development of hammertoes. Wearing proper-fitting shoes and custom orthotic devices can provide the support patients need to address muscle/tendon dysfunction. It can also support end stage diseases that result in hammertoe deformities by re-balancing the foot and ankle and controlling the deforming forces.

Hammer Toe Repair Recovery

Hammer ToeOverview

A Hammer toe is a toe that is contracted at the PIP joint (middle joint in the toe), potentially leading to severe pressure and pain. Ligaments and tendons that have tightened cause the toe’s joints to curl downwards. Hammer toes may occur in any toe except the big toe. There is often discomfort at the top part of the toe due to rubbing against the shoe.

Causes

Most hammertoes are caused by wearing ill-fitting, tight or high-heeled shoes over a long period of time. Shoes that don?t fit well can crowd the toes, putting pressure on the middle toes and causing them to hammertoe curl downward. Other causes include genes. Some people are born with hammertoe, bunions. These knobby bumps sometimes develop at the side of the big toe. This can make the big toe bend toward the other toes. The big toe can then overlap and crowd the smaller toes. Arthritis in a toe joint can lead to hammertoe.

HammertoeSymptoms

A hammertoe may be present but not always painful unless irritated by shoes. One may have enlarged toe joints with some thickened skin and no redness or swelling. However, if shoes create pressure on the joint, the pain will usually range from pinching and squeezing to sharp and burning. In long standing conditions, the dislocated joints can cause the pain of arthritis.

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

The most common treatment is to wear more comfortable shoes. When choosing a shoe, make sure the toe area is high and broad and has enough room for hammer toes. If there is chronic pain, surgery may be needed to correct a malalignment. Surgical treatments are aimed at loosening up the contracted toe joints to allow them to align properly. Other types of treatment are products designed to relieve hammer toes, such as hammer toe crests and hammer toe splints. These devices will help hold down the hammer toe and provide relief to the forefoot. Gel toe shields and gel toe caps can also be used. Gel toe shields and toe caps will help eliminate friction between the shoe and the toe, while providing comfort and lubrication.

Surgical Treatment

If these treatments are not sufficient at correcting the hammer toe, an operation to straighten the toe may be necessary. This is often performed in conjunction with surgery for a bunion deformity. The surgical treatment of a hammer toe can consist of either cutting the tendons to relieve the pressure that causes the deformity, or fusing the toe so that it points straight permanently.

Hammer ToePrevention

Plainly put, most toe deformities are caused by footwear. If you wish to avoid bunions or hammertoes, or works towards reversing them, please choose your footwear that has a low heel, and is wide enough in the toebox to spread you toes. Your podiatrist or therapist can help with the manipulation exercises. Bunion splints are available.

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