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2015.07.11
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カテゴリ:カテゴリ未分類

Overview
A Hammertoe can be flexible or rigid. Hammertoes often start out flexible and become rigid over time as your toe becomes accustomed to its crooked position. Flexible hammertoes are less serious than rigid hammertoes, as they can be easily diagnosed and treated in their initial stages. Flexible hammertoes are named as such because your affected toe still possesses some degree of movement.

Causes
A hammer toe develops because of an abnormal balance of the muscles in the toes. This abnormal balance causes increased pressures on the tendons and joints of the toe, leading to its contracture. Heredity and trauma can also lead to the formation of a hammer toe. Arthritis is another factor, because the balance around the toe in people with arthritis is disrupted. Wearing shoes that are too tight and cause the toes to squeeze can also cause a hammer toe to form.

Symptoms
Well-developed hammertoes are distinctive due to the abnormal bent shape of the toe. However, there are many other common symptoms. Some symptoms may be present before the toe becomes overly bent or fixed in the contracted position. Often, before the toe becomes permanently contracted, there will be pain or irritation over the top of the toe, particularly over the joint. The symptoms are pronounced while wearing shoes due to the top of the toe rubbing against the upper portion of the shoe. Often, there is a significant amount of friction between the toe and the shoe or between the toe and the toes on either side of it. The corns may be soft or hard, depending on their location and age. The affected toe may also appear red with irritated skin. In more severe cases, blisters or open sores may form. Those with diabetes should take extra care if they develop any of these symptoms, as they could lead to further complications.

Diagnosis
The earlier a hammertoe is diagnosed, the better the prognosis and treatment options. Your doctor will be able to diagnose your hammertoe with a simple examination of the foot and your footwear. He or she may take an x-ray to check the severity of the condition. You may also be asked about your symptoms, your normal daily activities, and your medical and family history.

Non Surgical Treatment
Symptoms of hammer toe might be helped through corn pads or cushions to alleviate them. If the person's hammer toes were caused by an underlying disease, the person should ask for their doctor's advice prior to performing any exercises without consent. It is also important for a person with hammer toes to remember that they must not attempt to treat or remove corns by themselves. If open cuts result from attempts to remove them, an infection becomes a very real possibility. People who experience diabetes or conditions that lead to poor circulation in their feet need to be especially careful.

Surgical Treatment
Probably the most frequent procedure performed is one called a Post or an Arthroplasty. In this case a small piece of bone is removed from the joint to straighten the toe. The toe is shortened somewhat, but there is still motion within the toe post-operatively. In other cases, an Arthrodesis is performed. This involves fusing the abnormally-contracted joint. The Taylor procedure fuses only the first joint in the toe, whereas the Lambrinudi procedure fuses both joints within the toe. Toes which have had these procedures are usually perfectly straight, but they take longer to heal and don't bend afterwards. A Hibbs procedure is a transfer of the toe's long extensor tendon to the top of the metatarsal bone. The idea of this procedure is to remove the deforming cause of the hammertoes (in this case, extensor substitution), but to preserve the tendon's function in dorsifexing the foot by reattaching it to the metatarsals. Fortunately, the Gotch (or Gotch and Kreuz) procedure--the removal of the base of the toe where it attaches to the foot, is done less frequently than in years past. The problem with this procedure is that it doesn't address the problem at the level of the deformity, and it causes the toe to become destabilized, often resulting in a toe that has contracted up and back onto the top of the foot. You can even have an Implant Arthroplasty procedure, where a small, false joint is inserted into place. There are several other procedures, as well.

Prevention
wear sensible shoes. Here are some tips. Most people have one foot that's bigger than the other. Fit your shoes to the bigger foot. Buy your shoes at the end of the day as your feet tend to swell a bit and you will get a better sense of fit. When you buy your shoes, wear the sock that you will be using when wearing that shoe - wear a sports sock when buyingtrainers, for example. As you get older, your feet get bigger. Get your feet measured every time you buy shoes. Don't go by shoe sizes. Shoe sizes vary among manufacturers; a shoe is the right size only when it fits comfortably. The ball of your foot should fit into the widest part of the shoe. A shoe should be sturdy so that it only bends in the ball of the foot, exactly where your big toes bend. Any shoe that can be bent anywhere along the sole or twisted side to side is generally too flimsy. There should be at least 1.5 cm between the tip of your longest toe and the front of the shoe. Never buy shoes that feel tight and expect them to stretch with wearing. If you have prominent areas on your feet such as hammer toes and bunions, avoid shoes with a lot of stitching or multiple pieces of fabric, as these stitched areas tend not to stretch to accommodate various toe deformities. Your shoes shouldn't ride up and down on your heel as you walk. The higher the heel, the less safe the shoe. Check children's shoes regularly.






最終更新日  2015.07.11 07:52:23
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