HEALTH ISSUES

Neuroma

Gout

Plantar Fasciitis

Proper Fitting Shoes

Hammertoes

Hammertoes

An inherited muscle imbalance or abnormal bone size can make any number of toes buckle. The joints in time “contract” causing tendons to shorten. Corns or calluses can result from the deformity.

Hammertoes are either a flexible or rigid contracture of any of the smaller toes. One or any number may form on any one foot. Even the big toe can “contract” in some instances. This contracture typically occurs at the first toe joint (the one closest to your heel), however, it may occur at the more distal joint. In these circumstances, when the more distal joint is involved, the term “mallet toe” is more appropriate. If both joints are contracted, then the term “claw toe” is used. Hammertoes can also cause pain, corns, and calluses in-between the toes. This most commonly occurs, in-between the fourth and fifth toes.

Shoes, activities, and even arthritis in most cases are not necessarily the leading cause of this deformity. Typically, one’s own inherited foot structure is the cause. This accounts for the strong family inheritance of this deformity. In some cases, having a “crooked toe” does not mean it may lead to a problem. However, unremitting sores, corns, and calluses can form in time. This can make the wearing of some shoes uncomfortable and difficult. Conservative care can be helpful but must be usually continued at routine intervals for what can be a lifetime.

Treatment should depend on many factors, such as: the patient’s complaint, responsiveness to conservative care, patient’s age, and other relevant medical history or problems. Conservative care may include doing nothing, staying out of tight fitting shoes, padding the toe, occasional trimming any build up of dead skin (corns and calluses), and the application of a pumice stone and moisturizing lotion at home. Additionally, shoe gear modifications can be helpful as well as arch supports or orthotics. When conservative care fails to provide relief, surgery may be indicated.

Surgical correction typically involves one or both of two major types of corrections: soft-tissue and bony. Soft tissue correction is usually indicated for any “flexible” deformity. Soft tissue correction involves releasing ligaments and tendons. Bony correction is indicated for any “rigid” deformity and usually involves realigning or partial removal of bone. It should also be noted that flexible deformities can develop into more rigid deformities.

Hammertoes tend not to resolve by themselves and unfortunately they tend to worsen with time. Surgical correction is done on an out-patient basis, usually utilizing local anesthesia with sedation. Most surgeries allow you to walk-in and walk-out of the surgery facility on the same day. Orthotics and/or good arch supportive shoes may be discussed and encouraged after surgery to lessen the chance of re-occurrence. Prior to any surgery, your doctor will thoroughly discuss the proposed correction and the appropriate after-care.