Overview
Hammertoes usually start out as mild deformities and get progressively worse over time. In the earlier stages, hammertoes are flexible and the symptoms can often be managed with changes in shoe styles and foot care products. But if left untreated, hammertoes can become more rigid and painful. Corns are more likely to develop as time goes on-and corns never really go away, even after trimming. In more severe cases of hammertoes, corn lesions may evolve into severe ulcerations. These lesions frequently occur in patients who have vascular disease or are Diabetic with neuropathy. The ulcerations can extend to the bone and result in infection and possible loss of digit or amputation.
Causes
While there are a number of causes, there aren't many specific risk factors for hammertoes, women tend to get these problems more than men, but they occur without rhyme or reason. Diabetics, however, are more likely to get a hammertoe if they have underlying nerve damage in the toes and feet.
Symptoms
The symptoms of hammertoe are progressive, meaning that they get worse over time. Hammertoe causes the middle joint on the second, third, fourth, or fifth toes to bend. The affected toe may be painful or irritated, especially when you wear shoes. Areas of thickened skin (corns) may develop between, on top of, or at the end of your toes. Thickened skin (calluses) may also appear on the bottom of your toe or the ball of your foot. It may be difficult to find a pair of shoes that is comfortable to wear.
Diagnosis
The exam may reveal a toe in which the near bone of the toe (proximal phalanx) is angled upward and the middle bone of the toe points in the opposite direction (plantar flexed). Toes may appear crooked or rotated. The involved joint may be painful when moved, or stiff. There may be areas of thickened skin (corns or calluses) on top of or between the toes, a callus may also be observed at the tip of the Hammer toe affected toe beneath the toenail. An attempt to passively correct the deformity will help elucidate the best treatment option as the examiner determines whether the toe is still flexible or not. It is advisable to assess palpable pulses, since their presence is associated with a good prognosis for healing after surgery. X-rays will demonstrate the contractures of the involved joints, as well as possible arthritic changes and bone enlargements (exostoses, spurs). X-rays of the involved foot are usually performed in a weight-bearing position.
Non Surgical Treatment
Wearing proper footwear may ease your foot pain. Low-heeled shoes with a deep toe box and flexible material covering the toes may help. Make sure there's a half-inch of space between your longest toe and the inside tip of your shoe. Allowing adequate space for your toes will help relieve pressure and pain. Avoid over-the-counter corn-removal products, many of which contain acid that can cause severe skin irritation. It's also risky to try shaving or cutting an unsightly corn off your toe. Foot wounds can easily get infected, and foot infections are often difficult to treat, especially if you have diabetes or poor circulation.
Surgical Treatment
Extreme occurrences of hammer toe may call for surgery. Your surgeon will decide which form of surgery will best suit your case. Often, the surgeon may have to cut or remove a tendon or ligament. Depending on the severity of your condition, the bones on both sides of the joint afflicted may need to be fused together. The good news is you can probably have your surgery and be released to go home in one day. You will probably experience some stiffness in your toe, but it might last for a short period, then your long-term pain will be eliminated.
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.
Hammertoes usually start out as mild deformities and get progressively worse over time. In the earlier stages, hammertoes are flexible and the symptoms can often be managed with changes in shoe styles and foot care products. But if left untreated, hammertoes can become more rigid and painful. Corns are more likely to develop as time goes on-and corns never really go away, even after trimming. In more severe cases of hammertoes, corn lesions may evolve into severe ulcerations. These lesions frequently occur in patients who have vascular disease or are Diabetic with neuropathy. The ulcerations can extend to the bone and result in infection and possible loss of digit or amputation.
Causes
While there are a number of causes, there aren't many specific risk factors for hammertoes, women tend to get these problems more than men, but they occur without rhyme or reason. Diabetics, however, are more likely to get a hammertoe if they have underlying nerve damage in the toes and feet.
Symptoms
The symptoms of hammertoe are progressive, meaning that they get worse over time. Hammertoe causes the middle joint on the second, third, fourth, or fifth toes to bend. The affected toe may be painful or irritated, especially when you wear shoes. Areas of thickened skin (corns) may develop between, on top of, or at the end of your toes. Thickened skin (calluses) may also appear on the bottom of your toe or the ball of your foot. It may be difficult to find a pair of shoes that is comfortable to wear.
Diagnosis
The exam may reveal a toe in which the near bone of the toe (proximal phalanx) is angled upward and the middle bone of the toe points in the opposite direction (plantar flexed). Toes may appear crooked or rotated. The involved joint may be painful when moved, or stiff. There may be areas of thickened skin (corns or calluses) on top of or between the toes, a callus may also be observed at the tip of the Hammer toe affected toe beneath the toenail. An attempt to passively correct the deformity will help elucidate the best treatment option as the examiner determines whether the toe is still flexible or not. It is advisable to assess palpable pulses, since their presence is associated with a good prognosis for healing after surgery. X-rays will demonstrate the contractures of the involved joints, as well as possible arthritic changes and bone enlargements (exostoses, spurs). X-rays of the involved foot are usually performed in a weight-bearing position.
Non Surgical Treatment
Wearing proper footwear may ease your foot pain. Low-heeled shoes with a deep toe box and flexible material covering the toes may help. Make sure there's a half-inch of space between your longest toe and the inside tip of your shoe. Allowing adequate space for your toes will help relieve pressure and pain. Avoid over-the-counter corn-removal products, many of which contain acid that can cause severe skin irritation. It's also risky to try shaving or cutting an unsightly corn off your toe. Foot wounds can easily get infected, and foot infections are often difficult to treat, especially if you have diabetes or poor circulation.
Surgical Treatment
Extreme occurrences of hammer toe may call for surgery. Your surgeon will decide which form of surgery will best suit your case. Often, the surgeon may have to cut or remove a tendon or ligament. Depending on the severity of your condition, the bones on both sides of the joint afflicted may need to be fused together. The good news is you can probably have your surgery and be released to go home in one day. You will probably experience some stiffness in your toe, but it might last for a short period, then your long-term pain will be eliminated.
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.