Clare Nuriddin

Foot Nail Problems

Hammer Toe Shortening Surgery

HammertoeOverview

Hammer toe is defined as a deformity in the toe where part of the toe is permanently bent downward resembling a hammer. Two related conditions are mallet toe and claw toe which effect different toe joints in slightly different ways. The key difference is that hammertoe tends to effect the middle joint in the toe (note: not the middle toe, the middle toe joint). The disease is usually associated with the second largest toe but can effect the third or fourth toe as well. Mallet toe effects the uppermost toe joint whereas claw toe is caused by the tow being held in a cramped ?claw-like? position.

Causes

Poorly fitting hammertoes shoes and muscle imbalances are the most common causes of hammertoe. When shoes are too narrow or do not accommodate the shape and size of your feet, they often contort the position of your toes. Choosing a shoe that fits is very important when it comes to avoiding foot problems like bunions or hammertoe. Having your toes bent for an extended period of time in a shoe that is too narrow or small forces your toes to adapt to the cramped space. With time, the muscles in your feet become accustomed to holding the flexed position of your toes, making it harder, or even impossible to straighten them.

HammertoeSymptoms

The symptoms of a hammer toe are usually first noticed when a corn develops on the top of the toe and becomes painful, usually when wearing tight shoes. There may be a bursa under the corn or instead of a corn, depending on the pressure. Most of the symptoms are due to pressure from footwear on the toe. There may be a callus under the metatarsal head at the base of the toe. Initially a hammer toe is usually flexible, but when longstanding it becomes more rigid.

Diagnosis

Hammertoes are progressive, they don?t go away by themselves and usually they will get worse over time. However, not all cases are alike, some hammertoes progress more rapidly than others. Once your foot and ankle surgeon has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.

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

Ordinary hammertoe procedures often use exposed wires which extend outside the end of toes for 4-6 weeks. Common problems associated with wires include infection where the wires come out of the toe, breakage, pain from hitting the wire, and lack of rotational stability causing the toe to look crooked. In addition, wires require a second in-office procedure to remove them, which can cause a lot of anxiety for many patients. Once inserted, implants remain within the bone, correcting the pain and deformity of hammertoes while eliminating many of the complications specific traditional treatments.

HammertoePrevention

The number-one hammertoe prevention tip is to wear properly fitting shoes. If your shoes feel too snug, go to your local shoe store and have the length and width of your feet measured. If you wear high heels, keep the heel height to 2 inches or less. Wearing shoes with high heels increases the pressure on your toes and causes them to bend. It can also cause the formation of corns and a high arch.