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2015.07.08
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カテゴリ:カテゴリ未分類

Overview
Hammer toes affects both joints of a toe, causing the toe to bend upwards at the proximal joint (the joint closest to the foot) and down at the distal joint (the one farthest away from the foot). The resulting unnatural bend is often compared to an upside down "V" and also to a hammer or a claw (The condition is sometimes referred to as clawtoe or clawfoot). A similar condition, in which the first joint of a toe simply bends downward, is called mallet toe. Since the arched bending of hammertoe often causes the toe to rub against the top of the shoe's toe box and against the sole, painful corns and calluses develop on the toes. Hammertoe can also be a result of squeezing within a too-small or ill-fitting shoe or wearing high heels that jam your toes into a tight toe box inside your shoe, arthritis, trauma and muscle and nerve damage from diseases such as diabetes. Probably because of the tight-shoe and high-heel shoe factors, hammertoe tends to occur far more often in women than in men.

Causes
Hammer toe results from shoes that don?t fit properly or a muscle imbalance, usually in combination with one or more other factors. Muscles work in pairs to straighten and bend the toes. If the toe is bent and held in one position long enough, the muscles tighten and cannot stretch out. Some other causes are diabetes, arthritis, neuromuscular disease, polio or trauma.

Symptoms
The most obvious symptom of hammer, claw or mallet toe is the abnormal toe position. This is usually combined with pain: the abnormal foot position leads to excessive friction on the toe as it rubs against any footwear which can be extremely painful. Corns & Calluses: repeated friction can result in the formation of a foot corn or callus on top of the toes. Stiffness, the joints become increasingly stiff. In the early stages, the toes can usually be straightened out passively using your hands, but if allowed to progress, the stiffness may be permanent.

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
There is a variety of treatment options for hammertoe. The treatment your foot and ankle surgeon selects will depend upon the severity of your hammertoe and other factors. A number of non-surgical measures can be undertaken. Padding corns and calluses. Your foot and ankle surgeon 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 shoewear. 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 toe box 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.

Surgical Treatment
Surgically correcting a hammertoe is very technical and difficult, and requires a surgeon with superior capabilities and experience. The operation can be done at our office or the hospital with local anesthetic. After making a small incision, the deformity is reduced and the tendons are realigned at the joint. You will be able to go home the same day with a special shoe! If you are sick and tired of not fitting your shoes, you can no longer get relief from pads, orthopedic shoes or pedicures, and have corns that are ugly, sensitive and painful, then you certainly may be a good surgical candidate. In order to have this surgery, you can not have poor circulation and and must have a clean bill of health.






最終更新日  2015.07.08 17:44:48
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