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2015.07.09
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Overview
Hammer toes is caused when the middle joint (PIP) bends down towards the floor (flexion). To compensate, the joints above and below (MTP, DIP) bend up (hyperextend). The result is that the middle part of the toe lifts up. Hammertoe is the most common deformity of the lesser toes (i.e. not the big toe). It tends to only affect one toe, most commonly the second.

Causes
Ill-fitting shoes or a muscle imbalance are the most common causes of Hammer Toe. If there is an issue with a muscle in the second, third or fourth toes preventing them from straightening, Hammer Toe can result. If one of these toes is bent long enough in one position, the muscles tighten and cannot stretch out. Left untreated, surgery may be required. Women are especially prone to developing Hammer Toe because of their shoes. Hammer Toe results from shoes that don?t fit properly. Shoes that narrow toward the toe, pushing smaller toes into a bend position for extended periods of time. High heels that force the foot down into a narrow space, forcing the toes against the shoe, increasing the bend in the toe.

Symptoms
Pain upon pressure at the top of the bent toe from footwear. The formation of corns on the top of the joint. Redness and swelling at the joint contracture. Restricted or painful motion of the toe joint. Pain in the ball of the foot at the base of the affected toe.

Diagnosis
Although hammertoes are readily apparent, to arrive at a diagnosis the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination, the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take x-rays to determine the degree of the deformities and assess any changes that may have occurred.

Non Surgical Treatment
Any forefoot problems that cause pain or discomfort should be given prompt attention. Ignoring the symptoms can aggravate the condition and lead to a breakdown of tissue, or possibly even infection. Conservative treatment of mallet toes begins with accommodating the deformity. The goal is to relieve pressure, reduce friction, and transfer forces from the sensitive areas. Shoes with a high and broad toe box (toe area) are recommended for people suffering from forefoot deformities such as mallet toes. This prevents further irritation in the toe area from developing. Other conservative treatment includes forefoot supports such as gel toe caps, gel toe shields and toe crests. Gel forefoot supports provide immediate comfort and relief from common forefoot disorders without drying the skin.

Surgical Treatment
he basis for hammer toe surgery most often involves removing s portion of bone within the toe, to reduce the joint contracture. Depending on the direction the toe is deviated, soft tissue procedures may be necessary along with pinning the toe with a surgical wire.

Prevention
You can avoid many foot, heel and ankle problems with shoes that fit properly. Here's what to look for when buying shoes. Adequate toe room. Avoid shoes with pointed toes. Low heels. Avoiding high heels will help you avoid back problems. Adjustability. Laced shoes are roomier and adjustable.






最終更新日  2015.07.09 22:03:14
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