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21 Agos 2015 

Hammer Toes Symptoms

HammertoeOverview


If you sneak a peek at your feet and notice that your toes are crossed, bent, or just pointing at an odd angle, you probably suffer from a hammertoe. Toes that are scrunched up inside tight shoes or pressed against the toe box of the shoe can bend at the joints and stay that way - resulting in a hammertoe. A hammertoe is a contracture of the toe at one of the two joints in the toe. Due to the pull of the tendons, the joints become more rigid over time. The toe is bent up at the joint and does not straighten out.


Causes


Hammer toe results from shoes that don?t fit properly or a muscle imbalance, usually in combination with one or more other factors. Muscles work in pairs to straighten and bend the toes. If the toe is bent and held in one position hammertoes long enough, the muscles tighten and cannot stretch out. Some other causes are diabetes, arthritis, neuromuscular disease, polio or trauma.


Hammer ToeSymptoms


If the toes remain in the hammertoe position for long periods, the tendons on the top of the foot will tighten over time because they are not stretched to their full length. Eventually, the tendons shorten enough that the toe stays bent, even when shoes are not being worn. The symptoms of hammertoe include a curling toe, pain or discomfort in the toes and ball of the foot or the front of the leg, especially when toes are stretched downward, thickening of the skin above or below the affected toe with the formation of corns or calluses, difficulty finding shoes that fit well. In its early stages, hammertoe is not obvious. Frequently, hammertoe does not cause any symptoms except for the claw-like toe shape.


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 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


If the toes are still mobile enough that they are able to stretch out and lay flat, the doctor will likely suggest a change of footwear. In addition, she may choose to treat the pain that may result from the condition. The doctor may prescribe pads to ease the pain of any corns and calluses, and medications ranging from ibuprofen to steroid injections for the inflammation and pain. Other options for non-surgical treatments include orthotic devices to help with the tendon and muscle imbalance or splinting to help realign the toe. Splinting devices come in a variety of shapes and sizes but the purpose of each is the same: to stretch the muscles and tendon and flatten the joint to remove the pain and pressure that comes from corns.


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.


Hammer ToePrevention


Good circulation is essential. When you're sitting down, put your feet up. If you've been sitting for a while, stretch your legs and feet. Give yourself a foot massage or trade foot massages with someone you love. A warm foot bath is also a good idea. Most people have one foot that's bigger than the other. Fit your shoes to the bigger foot. Buy shoes at the end of the day, as feet tend to swell a bit and you will get a better sense of fit. When buying shoes, wear the socks that you will be using when wearing that shoe. For example, wear an athletic sock when buying athletic shoes and a dress sock when purchasing dress shoes. If the shoe does not feel good at the time of purchase, then it will never feel good.
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