hammertoe is a deformity of the toe in which the toe bends downward at the middle joint, causing it to resemble a hammer. Hammertoes usually begin as mild problems, but over time they can develop into severe cases. Hammertoes are often flexible during the initial stages, and if treatment is administered promptly, symptoms can be managed with non-surgical methods. But if time passes and you do not seek treatment, your hammertoe will become more rigid, and surgical treatment may be required.
Hammer toes are most frequently Hammer toes caused by a muscle - tendon imbalance in the foot, and are seen both in adults and children. Foot muscles work in pairs to straighten and bend the toes. If your foot has a biomechanical defect, the muscles tighten and the tendons shorten. Eventually, the toe muscles can?t straighten the toe, even when barefoot. Contributing factors are poor choices in footwear, arthritis, or trauma.
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.
The treatment options vary with the type and severity of each hammer toe, although identifying the deformity early in its development is important to avoid surgery. Your podiatric physician will examine and X-ray the affected area and recommend a treatment plan specific to your condition.
Non Surgical Treatment
Conservative treatment starts with new shoes that have soft, roomy toe boxes. Shoes should be one-half inch longer than your longest toe. (Note: For many people, the second toe is longer than the big toe.) Avoid wearing tight, narrow, high-heeled shoes. You may also be able to find a shoe with a deep toe box that accommodates the hammer toe. Or, a shoe specialist (Pedorthist) may be able to stretch the toe box so that it bulges out around the toe. Sandals may help, as long as they do not pinch or rub other areas of the foot.
Surgery to correct for a hammertoe may be performed as an outpatient procedure at a hospital, surgery center, or in the office of your podiatrist. There are multiple procedures that can be used depending on your individual foot structure and whether the deformity is flexible or rigid. There may be a surgical cut in the bone to get rid of an exostosis, or a joint may be completely removed to allow the toe to lay straight.
A bunion (hallux valgus) is an enlargement of the bone or tissue around a joint at the base of the big toe or at the base of the little toe (in which case it is called a "bunionette" or "tailor's bunion"). Bunions often occur when the joint is stressed over a prolonged period. Ninety percent of bunions occur in women, primarily because women may be more likely to wear tight, pointed, and confining shoes. Bunions may be inherited as a family trait. Bunions may also result from arthritis, which often affects the big toe joint.
Improper footwear. Podiatric physicians have long believed that narrow, poor-fitting shoes with a tight toe box tend to compress the end of the foot, leading to abnormal motion of the foot and pressure over the MTP joint. High-heeled shoes tend to add even more pressure to the toes, as the foot slides downward. Over time, continued pressure will squeeze the toes together, encouraging the deformity. Occupational hazards. Individuals whose jobs place undue stress on their feet are among those who complain of bunions. Ballet dancers, in particular, put great demands on their toes, and thus are often subject to bunions, however, they are not alone. Many professionals whose jobs require a great deal of standing or walking (teachers, police officers, doctors and nurses, etc.) and/or who are required to wear a particular type of shoe or boot as part of a uniform, also are at risk. Athletes such as runners or walkers, who utilize the wrong footwear, may also develop bunions.
SymptomsPain or soreness. Inflamattion and redness. A burning sensation. Numbness on the side of the great toe. Other conditions which may occur secondary to bunions include calluses on the big toe, sore between the toes, ingrown toenails, and stiffness of the joint where the great toe attaches to the foot.
The doctor considers a bunion as a possible diagnosis when noting the symptoms described above. The anatomy of the foot, including joint and foot function, is assessed during the examination. Radiographs (X-ray films) of the foot can be helpful to determine the integrity of the joints of the foot and to screen for underlying conditions, such as arthritis or gout. X-ray films are an excellent method of calculating the alignment of the toes when taken in a standing position.
Non Surgical Treatment
Many people with bunions are quite comfortable if they wear wide, well fitting shoes and give them time to adapt to the shape of their feet. A small pad over the bony prominence, which can be bought from a chemist or chiropodist, can take the pressure of the shoe off the bunion. High heels tend to squeeze the foot into the front of the shoe and should be avoided. It is often worthwhile seeing a chiropodist if these simple measures are not quite enough.
Surgery takes place either under local or general anaesthetic and takes about one hour. After surgery you will have either a plaster cast or special dressing on the foot and you will be given a special walking shoe and crutches to use the first few days/weeks. Recovery usually takes approximately 6-8 weeks but swelling often lasts longer and it may take a few months before you are able to wear normal shoes again. Full recovery can take up to a year. Bunion surgery is successful in approximately 85% of cases, but it is vital not to go back to wearing ill-fitting shoes else the problem is likely to return.
Here are some tips to help you prevent bunions. Wear shoes that fit well. Use custom orthotic devices. Avoid shoes with small toe boxes and high heels. Exercise daily to keep the muscles of your feet and legs strong and healthy. Follow your doctor?s treatment and recovery instructions thoroughly. Unfortunately, if you suffer from bunions due to genetics, there may be nothing you can do to prevent them from occurring. Talk with your doctor about additional prevention steps you can take, especially if you are prone to them.
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