What is a hammer toe. How does it develop. What are the symptoms of hammer toe. How is hammer toe diagnosed. What are the nonsurgical treatment options for hammer toe. When is surgery necessary for hammer toe. How can hammer toe be prevented.

Understanding Hammer Toe: A Comprehensive Overview

Hammer toe is a common foot deformity that affects the second, third, or fourth toes. This condition causes the affected toe to bend abnormally at the middle joint, resembling the shape of a hammer. While initially flexible, hammer toes can become rigid over time if left untreated, potentially requiring surgical intervention.

What Causes Hammer Toe?

Hammer toe results from a muscle imbalance that puts pressure on the toe tendons and joints. This imbalance can be caused by various factors:

• Ill-fitting shoes, particularly those with narrow toe boxes or high heels
• Genetics
• Trauma or injury to the toe
• Certain medical conditions, such as arthritis or diabetes
• Aging and natural changes in foot structure

The most common culprit is wearing shoes that don’t fit properly. Shoes that narrow toward the toe can force the smaller toes into a flexed position, leading to the development of hammer toe over time.

Recognizing the Symptoms of Hammer Toe

Identifying hammer toe early can lead to more effective treatment and prevention of complications. Common symptoms include:

• Pain in the affected toe, especially when moving it or wearing shoes
• Swelling or redness around the toe joint
• Difficulty straightening the toe
• Corns or calluses on the top of the middle joint or tip of the toe
• Challenges with walking or wearing certain types of shoes

If you experience any of these symptoms, it’s essential to consult a healthcare professional for proper diagnosis and treatment.

Diagnosing Hammer Toe: What to Expect

When you visit a doctor for suspected hammer toe, they will likely perform a thorough physical examination. This examination helps determine whether the toe joint is flexible or rigid, which is crucial for developing an appropriate treatment plan.

Diagnostic Tests for Hammer Toe

In addition to the physical examination, your doctor may recommend the following diagnostic tests:

• X-rays: These imaging tests provide clear images of bone structures, helping confirm the diagnosis and assess the severity of the deformity.
• Neurological tests: For patients with diabetes or decreased sensation in their feet, additional testing may be necessary to determine if a neurological condition is contributing to the muscle imbalance.

Nonsurgical Treatment Options for Hammer Toe

In the early stages of hammer toe, when the joint is still flexible, treatment typically involves conservative measures. These may include:

1. Changes in footwear: Opting for shoes with a wider toe box and lower heels can help alleviate pressure on the affected toe.
2. Orthotic devices: Custom-made shoe inserts or pads can help redistribute pressure and provide support to the affected toe.
3. Exercises: Specific toe exercises can help strengthen and stretch the muscles, improving flexibility and potentially correcting the deformity.
4. Medications: Over-the-counter pain relievers may be recommended to manage discomfort associated with hammer toe.
5. Splinting or taping: These techniques can help hold the toe in a proper position, potentially alleviating pain and preventing further deformity.

Surgical Interventions for Hammer Toe

When conservative treatments fail to provide relief or the hammer toe becomes rigid, surgical intervention may be necessary. The type of surgery depends on the severity of the deformity and may include:

• Tendon transfer: This procedure involves rerouting tendons to release the bent joint and restore balance.
• Joint resection: Part of the toe joint is removed to allow for straightening.
• Fusion: The affected joint is permanently fused in a straight position.

Recovery time varies depending on the procedure, but most patients can return to normal activities within a few weeks to months after surgery.

Preventing Hammer Toe: Proactive Measures

While not all cases of hammer toe can be prevented, there are several steps you can take to reduce your risk:

• Wear properly fitting shoes with adequate toe room
• Avoid high heels or shoes that put excessive pressure on your toes
• Exercise your feet regularly to maintain flexibility and strength
• Address any foot pain or discomfort promptly
• Manage underlying conditions, such as diabetes or arthritis, that may contribute to foot problems

Living with Hammer Toe: Lifestyle Adjustments and Coping Strategies

For individuals living with hammer toe, certain lifestyle adjustments can help manage symptoms and improve quality of life:

1. Invest in comfortable, supportive footwear
2. Use protective pads to prevent friction and reduce pressure on the affected toe
3. Practice good foot hygiene to prevent complications, especially if you have diabetes
4. Engage in low-impact exercises that don’t put excessive stress on your feet
5. Consider alternative therapies, such as massage or acupuncture, for pain management

Hammer Toe in Special Populations: Considerations and Approaches

Certain groups may require special consideration when it comes to hammer toe diagnosis and treatment:

Hammer Toe in Children

Hammer toe can occur in children, often due to congenital factors or neuromuscular conditions. Early intervention is crucial to prevent long-term complications and ensure proper foot development.

Hammer Toe in Older Adults

As we age, the risk of developing hammer toe increases. Older adults may also face additional challenges in treatment due to other health conditions or reduced mobility.

Hammer Toe and Diabetes

People with diabetes are at higher risk for foot complications, including hammer toe. Proper foot care and regular check-ups are essential to prevent serious complications.

The Future of Hammer Toe Treatment: Emerging Technologies and Research

As medical science advances, new approaches to treating hammer toe are being developed:

• Minimally invasive surgical techniques that offer faster recovery times
• Advanced materials for orthotic devices and surgical implants
• Gene therapy research aimed at addressing underlying genetic factors
• Regenerative medicine approaches using stem cells to promote healing

These innovations hold promise for more effective and less invasive treatments in the future.

Hammer Toe and Overall Foot Health: A Holistic Approach

Understanding hammer toe within the context of overall foot health is crucial for comprehensive care:

The Importance of Regular Foot Examinations

Regular check-ups with a podiatrist or orthopedic specialist can help catch foot problems early, including hammer toe, and prevent them from progressing.

Foot Exercises for General Health

Incorporating foot exercises into your daily routine can improve overall foot strength and flexibility, potentially reducing the risk of conditions like hammer toe.

The Role of Nutrition in Foot Health

A balanced diet rich in calcium, vitamin D, and other essential nutrients can contribute to strong bones and healthy feet, potentially reducing the risk of foot deformities.

By taking a proactive approach to foot health and addressing hammer toe symptoms early, individuals can maintain mobility, reduce pain, and improve their overall quality of life. Whether through conservative treatments or surgical interventions, effective management of hammer toe is possible with proper care and attention to foot health.

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hammer-zehen – hammertoe stock-fotos und bilder

Hammer-Zehen

hammerzehendeformität des fußes – hammertoe stock-fotos und bilder

Hammerzehendeformität des Fußes

knochen – analysieren – hammertoe stock-grafiken, -clipart, -cartoons und -symbole

Knochen – Analysieren

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Ein paar Stunden nach der Operation eingewickelter und. ..

Bandagierter Fuß einige Stunden nach einer Ballenzehen- und Hammerzehenoperation am rechten Fuß einer Frau in ihren 60ern.

einer sitzung plantar reflexzonenmassage im park – hammertoe stock-fotos und bilder

Einer Sitzung plantar Reflexzonenmassage im park

Professioneller Masseur während einer Sitzung der Plantarreflexzonenmassage, Klopfen mit einem winzigen Hammer

knochen – hammertoe stock-grafiken, -clipart, -cartoons und -symbole

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Frau tritt auf Holzbrett mit scharfen Metallnägeln Sadhu Yoga…

konstruktionswerkzeuge, doodle-vektor-set von reparaturelementen, cartoon-symbole. – hammertoe stock-grafiken, -clipart, -cartoons und -symbole

Konstruktionswerkzeuge, Doodle-Vektor-Set von Reparaturelementen,

Konstruktionswerkzeuge, Doodle-Vektor-Set von Reparaturelementen, Cartoon-Symbole

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Hausreparatur und -dekoration rote, schwarze dünne Liniensymbole,

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Konstruktion Dachdecker total an Bord mit hammer Holz

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Hochbau und Reparatur rot schwarz dünne linie ausrüstung und…

Hammer Toe – OrthoInfo – AAOS

A hammer toe is a deformity of the second, third or fourth toes. In this condition, the toe is bent at the middle joint, so that it resembles a hammer. Initially, hammer toes are flexible and can be corrected with simple measures but, if left untreated, they can become fixed and require surgery.

A hammer toe deformity of the second toe. Pressure from the patient’s shoe has caused a corn to develop on the raised portion of the toe.

The forefoot is made up of five toes. Each toe has three joints—except for the first (big) toe, which usually has only two joints.

In hammer toe, the affected toe is bent at the middle joint, which is called the proximal interphalangeal (PIP) joint.

This illustration of hammer toe shows the abnormal bend of the PIP joint.

Hammer toe is the result of a muscle imbalance that puts pressure on the toe tendons and joints. Muscles work in pairs to straighten and bend the toes. If the toe is bent in one position long enough, the muscles and joints tighten and cannot stretch out.

Wearing shoes that do not fit properly is a common cause of this imbalance. Shoes that narrow toward the toe push the smaller toes into a flexed (bent) position. The toes rub against the shoe, leading to the formation of corns and calluses, which further aggravate the condition. Shoes with a higher heel force the foot down and push the toes against the shoe, increasing the pressure and the bend in the toe. Eventually, the toe muscles can no longer straighten the toe.

A hammer toe is painful, especially when the patient is moving it or wearing shoes. Other symptoms may include:

• Swelling or redness
• Inability to straighten the toe
• Difficulty walking
• A corn or callus on the top of the middle joint of the toe or on the tip of the toe

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Physical Examination

Your doctor will perform a physical examination to determine if the toe joint is flexible or rigid. This information will help him or her determine the appropriate treatment.

Tests

X-rays. X-rays provide images of dense structures, such as bone. Your doctor may order an x-ray of your foot to confirm the diagnosis.

Other tests. Patients who have diabetes or decreased sensation in their feet may require further testing to determine whether a neurological condition is the cause of the tendon imbalance.

Nonsurgical Treatment

In the early stages of hammer toe—when the joint is still flexible—treatment typically consists of simple measures.

Changes in footwear. Your doctor will recommend that you avoid wearing tight, narrow, high-heeled shoes. Shoes should be one-half inch longer than your longest toe—which, for many people is the second toe—and have a soft, roomy toe box.

You may also be able to find a shoe with a deep toe box that accommodates the hammer toe. A shoe repair shop may be able to stretch a toe box so that it bulges out around the toe. Wearing sandals may help, if they do not pinch or rub other areas of the foot.

Exercises. Specific exercises can help stretch and strengthen the muscles in your foot. Your doctor may recommend gently stretching your toes manually or using your toes to pick things up off the floor. He or she may also recommend doing “towel curls” to strengthen the toes. To perform a towel curl, place a towel flat under your foot and use your toes to crumple it.

Doing “towel curls” can help strengthen the toes and restore muscle balance.

Over-the-counter remedies. Using commercially available straps, cushions or nonmedicated corn pads can help relieve pain. If you have diabetes, poor circulation, or a lack of feeling in your feet, talk to your doctor before attempting any self-treatment.

Surgical Treatment

If the toe joint is rigid and no longer moveable, or if nonsurgical treatment does not relieve your symptoms, your doctor may recommend surgery. Surgery is typically performed on an outpatient basis using a local anesthetic. The actual procedure will depend on the type and extent of the deformity.

Tendon lengthening. For patients with a flexible toe joint, the condition can often be treated by lengthening the tendons that are causing the joint imbalance.

Tendon transfer. Some patients with a flexible toe joint may benefit from treatment that involves transferring tendons from the bottom of the toe to the top of the toe to help pull the joint into a straight position.  

Arthrodesis (joint fusion). Patients who have a rigid toe joint may undergo tendon lengthening in combination with arthrodesis. In this procedure, your doctor will remove a small part of a bone in the toe joint to ensure that the toe can extend fully. He or she will then insert an external wire or pin and/or internal plate to hold the bones in place while the bones fuse together.

A) A hammer toe. B) In arthrodesis, a small amount of bone is first removed from the PIP joint. C) Here, a metal pin has been inserted to hold the bones in place until they fuse.

This patient’s three hammer toes have been corrected with arthrodesis. A metal pin has been inserted in each toe to hold the bones in place while they fuse. Plastic caps have been placed over the tips of the pins.

After surgery, you may experience some stiffness, swelling and redness in your toe for up to 4-6 weeks. Although you will be able to put pressure on the foot immediately after surgery, you should try to limit your activity while the toe heals. Elevating your foot as much as possible will help speed up healing and reduce pain. Once healed, your toe may be slightly longer or shorter than it was before.

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Hammertoes – Estmedica

We correct hammertoes with only 3 skin punctures (3-5mm) using minimally invasive surgery (MIS). Fixation of the bone with metal is not used, there are no foreign bodies.

Your MIS will be performed by a surgeon who is a member of AMIFAS * (* Academy of Minimally Invasive Foot & Ankle Surgery, USA))

Benefits of Minimally Invasive Surgery

• Less Trauma – MIS is less traumatic to soft tissues. Traditional open surgery requires large skin incisions (up to 10 cm), opening of the joints, metal fixation to correct the bone, which leads to damage to the bones and soft tissues. MIS, on the contrary, uses small skin holes with less tissue damage and faster recovery time. MIS does not use metal to fix the bone.
• Less Pain – Because MIS uses a less traumatic treatment, MIS patients experience less postoperative pain and need less pain medication.
• Shorter operation time – MIS often requires less time than traditional operations because MIS does not require permanent fixation of the bone with metal (screws and others) and surgical repair of the wound.
• Less scarring – Minimally invasive foot surgery uses skin punctures so scars are smaller and less visible.
• Less anesthesia – MIS does not require general anesthesia. We use regional anesthesia (ankle block) under ultrasound guidance for accurate and effective painless treatment. It also reduces the risk of general anesthesia. Ankle block lasts up to 5-6 hours, which is an added benefit for our patients.

Recovery after the procedure

• Immediately after the procedure, you can walk in a special inexpensive orthosis (7-10 days), then in ordinary loose shoes with a wide toe (from 3 to 5 weeks). You can walk as usual, no need for crutches or canes.

Our experience with percutaneous minimally invasive foot surgery (MIS)

Minimally invasive percutaneous surgery (MIS) has been used at the Estmedica clinic since 2011. Our clinic is the first in the Baltic States to use MIS for hammer toe, hallux valgus, metatarsalgia and any other deformities of the forefoot.

During the MIS procedure, 3-5 mm skin incisions are made. A specially designed X-ray Mini C-Arm is used by the surgeon to perform MIS.

New MIS technology reduces surgical trauma, scarring and post-treatment complications. There are no metal elements on the foot after MIS. Recovery after the MIS procedure is predictable and the risk of infection is lower.

Our surgeon Andrey Detochenko MD is a member of the Academy of Minimally Invasive Foot & Ankle Surgery, USA.

Minimally invasive surgery was first developed by Dr. Morton Polokoff (USA) at 1945 year. He developed these techniques as a system of percutaneous surgery using very small instruments.

Hammer toe deformity — Foot — Treatment — Personal website of orthopedist-traumatologist Sergey Yuryevich Dedov

2-3-4-5 fingers, the so-called small or lateral rays of the foot, are subject to hammer-shaped deformity.

This deformity is the result of flat feet to a greater extent, and can also be the result of diseases (rheumatoid arthritis, diabetes mellitus) or traumatic injuries.

Isolated hammer toe deformity is a rather rare situation, usually associated with other deformities of the forefoot (hallux valgus, metatarsalgia, Morton’s neuroma).

Let’s not go into the “wilds” of the pathogenesis of this disease, it is rather complicated. Briefly, I note that in most cases, the basis of hammer toe deformity is an imbalance in the capsular-ligamentous-tendon complex of 2-3-4 toes.

Symptoms:

• Cosmetic defect
• soreness when walking
• limitation of mobility in the joint
• inability to fit and wear standard footwear
• callus formation in the area of ​​the joints
• Appearance of plantar corns (hyperkeratosis) under metatarsal heads

Treatment:

Hammer toe deformity can be treated conservatively or surgically. In the initial stages of the disease, conservative treatment is possible. Free footwear is required. Various orthopedic products are used (hammer toe correctors, silicone rings, protective caps). These orthopedic products to a greater extent provide fixation and protection of the toe from friction in shoes, but cannot directly eliminate the deformation.

Despite the apparent “triviality” of the problem, surgical treatment of this deformity is rather complicated. Since it is necessary to carry out combined operations both on soft tissues (joint capsule, tendons) and osteoplastic operations.

1) arthrolysis of the metatarso-phalangeal joint

2) plantar arthrolysis of the interphalangeal joint

3) 4) transection of the tendons (flexor-extensor) of the finger

5) resection of the head of the proximal phalanx (Goman) or arthrodesis of the interphalangeal joint

6)7) osteotomy of the proximal or distal phalanx of the finger to eliminate rotational deformity

Currently, we perform all operations for hammer toe deformities using a mini-invasive method ( MIS).

The operation can be performed under local, conduction or spinal anesthesia (the choice of anesthesia depends on the extent of the operation).

Intraoperative x-ray control (EOP) is required for the operation.

Hammer finger flexor and extensor tendon tenotomies are performed using the Beaver© microscalpel using mini-punctures (1-2 mm).

Microburrs (Newdeal) are used to make osteotomies of the proximal (sometimes middle) phalanges of the hammertoe.

Sometimes, in the presence of persistent hammer-shaped deformity after osteotomy, we perform transarticular fixation of the finger with a microwire.

In combination with direct operations on the hammer toes, it is mandatory to perform distal subcapital osteotomies of the metatarsal bones (also minimally invasive).

The operation takes only 5-10 minutes!!!

After surgery:

Patients are activated immediately after surgery. No crutches or plaster! From day 1, patients walk in special postoperative orthopedic shoes (Baruka shoes) in order to unload the forefoot. Full walking in ordinary shoes is recommended on average 4-6 weeks after the operation.

Clinical example: