Hammertoes
Hammertoes are a foot condition characterized by a permanent bending of the toes at the joint closest to the foot, commonly affecting the second toe. This deformity can also manifest as clawtoes, where the toes bend at both joints. The primary causes include muscle imbalances, tendon contractions, enlargement of toe joints, and frequently, the wearing of improper footwear, particularly high heels or tight shoes. Symptoms often include pain, inflammation, corns, calluses, and in severe cases, skin ulcers due to friction with footwear. Treatment options range from conservative measures such as changing to more comfortable shoes and using corrective inserts to more invasive procedures like tendon cutting or joint repair in advanced cases. Individuals experiencing these symptoms may find significant relief through proper foot care and adjustments to their footwear choices. Understanding hammertoes is crucial as they can lead to complications that impede mobility and overall foot health.
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Subject Terms
Hammertoes
ANATOMY OR SYSTEM AFFECTED: Feet
DEFINITION: Toes that are bent permanently at the joint nearest to the foot; clawtoe: a toe that is bent at both joints
CAUSES: Muscle imbalance, tendon contraction, enlargement of toe joints, improper footwear
SYMPTOMS: Pain, inflammation, corns and calluses, skin ulcers
DURATION: Typically short-term
TREATMENTS: Change of footwear, use of corrective inserts or devices, sometimes arthroplasty or cutting of affected tendon
Causes and Symptoms
Hammertoes and clawtoes can occur in one or more of the four smaller toes on each foot, with the second toe being the most common site for these deformities. Hammertoes and clawtoes are thought to be caused by muscle imbalance, contraction of the tendons, and enlargement of the toe joints. Although anyone can develop these conditions, the majority of cases are caused by wearing high heels or shoes that are too tight. It is common for people to develop painful corns and calluses in association with these conditions, particularly on top or on the tip of the toe where it is most likely to rub against the shoe. Furthermore, people with hammertoes or clawtoes may experience considerable pain if the toe gets inflamed. Skin ulcers may also develop when the bent toe rubs against the shoe. These ulcers can become infected and develop abnormal channels to the skin surface called sinus tracts. These conditions may also cause significant problems with walking for the affected individual.
Treatment and Therapy
Treatment of hammertoes or clawtoes depends on the severity of the condition and whether there are secondary complications such as corns or ulcers. The simplest treatment is to change to shoes with broad toes and soft soles that cushion the foot and to avoid wearing high heels and shoes that pinch the toes. Accompanied by excellent foot care such as and corn removal, this may be all that is required to prevent pain and irritation of the toes. In cases that are more advanced, various inserts can be added to the shoes. These include metatarsal bars, orthotics, and other devices. A metatarsal bar supports the ball of the foot and spreads the pressure over a greater part of the foot. Orthotics are specially molded plastic devices that serve much the same purpose. In some cases, podiatrists (foot doctors) or orthopedists recommend toe caps, which are padded sleeves that help prevent friction between the toe and the shoe. In a few cases, it may be necessary to cut the tendons in the toe or to perform (repair of the joint itself) to provide relief.
Bibliography
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