Hammer toe

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Hammer toe
Other namesContracted toe
Hammer toes.jpg
Human feet with hammer toes
Specialty Podology, orthopedic surgery   OOjs UI icon edit-ltr-progressive.svg

A hammer toe, hammertoe or contracted toe is a deformity of the muscles and ligaments of the proximal interphalangeal joint of the second, third, fourth, or fifth toe, bending it into a shape resembling a hammer. In the early stage, a flexible hammertoe is movable at the joints; a rigid hammertoe joint cannot be moved and usually requires surgery. [1]

Contents

Mallet toe is a similar condition affecting the distal interphalangeal joint. [2]

Claw toe is another similar condition, with dorsiflexion of the proximal phalanx on the lesser metatarsophalangeal joint, combined with flexion of both the proximal and distal interphalangeal joints. Claw toe can affect the second, third, fourth, or fifth toes.

Risk factors

Older people are more likely to develop hammer toes. [3] Women are at higher risk, due to the construction of women's shoes. [1] Injuries to the toes, and being born with a big toe that is short in comparison to the second toe, increase risk. [3] Arthritis and diabetes may also increase the risk of foot deformities. [3]

Causes

A mallet toe is evident on the 3rd digit. Human foot with mallet toe.jpg
A mallet toe is evident on the 3rd digit.

Hammertoes and clawtoes have multiple causes. [4] [5] Hammer toe most frequently results from wearing poorly fitting shoes that can force the toe into a bent position, such as high heels or shoes that are too short or narrow for the foot. Having the toes bent for long periods of time can cause the muscles in them to shorten, resulting in the hammer toe deformity. This is often found in conjunction with bunions or other foot problems (e.g., a bunion can force the big toe to turn inward and push the other toes). [3]

The toe muscles work in pairs; if the muscles pulling in one direction are much weaker than those pulling in the other direction, the imbalance can bend the toe. If the bend persists, then as the tendons and ligaments tighten (as they do if not stretched[ medical citation needed ]), the bend may become permanent. [3] Ill-fitting shoes are especially likely to push the toes out of balance. [1]

Toe deformities can also be caused by muscle, nerve, or joint damage, resulting from conditions such as osteoarthritis, rheumatoid arthritis, stroke, Charcot–Marie–Tooth disease, complex regional pain syndrome or diabetes. [3] Hammer toe can also be found in Friedreich's ataxia (GAA trinucleotide repeat).

Corrective surgery for hammer toe Kamran Jamshidinia MD Hammertoe Surgery.jpg
Corrective surgery for hammer toe

Treatment

In many cases, conservative treatment consisting of physical therapy and new shoes with soft, spacious toe boxes is enough to resolve the condition, while in more severe or longstanding cases hammertoe surgery [6] may be necessary to correct the deformity. The patient's doctor may also prescribe some toe exercises that can be done at home to stretch and strengthen the muscles. For example, the individual can gently stretch the toes manually, or use the toes to pick things up off the floor.

Related Research Articles

<span class="mw-page-title-main">Foot</span> Anatomical structure found in vertebrates

The foot is an anatomical structure found in many vertebrates. It is the terminal portion of a limb which bears weight and allows locomotion. In many animals with feet, the foot is a separate organ at the terminal part of the leg made up of one or more segments or bones, generally including claws and/or nails.

<span class="mw-page-title-main">Toe</span> Digit of a foot

Toes are the digits of the foot of a tetrapod. Animal species such as cats that walk on their toes are described as being digitigrade. Humans, and other animals that walk on the soles of their feet, are described as being plantigrade; unguligrade animals are those that walk on hooves at the tips of their toes.

<span class="mw-page-title-main">Bunion</span> Deformity characterized by lateral deviation of the big toe

A bunion, also known as hallux valgus, is a deformity of the joint connecting the big toe to the foot. The big toe often bends towards the other toes and the joint becomes red and painful. The onset of bunions is typically gradual. Complications may include bursitis or arthritis.

<span class="mw-page-title-main">Osteophyte</span> Small abnormal bony outgrowth

Osteophytes are exostoses that form along joint margins. They should not be confused with enthesophytes, which are bony projections that form at the attachment of a tendon or ligament. Osteophytes are not always distinguished from exostoses in any definite way, although in many cases there are a number of differences. Osteophytes are typically intra-articular.

<span class="mw-page-title-main">Diseases of the foot</span>

Diseases of the foot generally are not limited, that is they are related to or manifest elsewhere in the body. However, the foot is often the first place some of these diseases or a sign or symptom of others appear. This is because of the foot's distance from the central circulation, the heart and its constant exposure to pressures from the ground and the weight of the body.

<span class="mw-page-title-main">Flat feet</span> Deformity in which the foot arches contact the ground

Flat feet, also called pes planus or fallen arches, is a postural deformity in which the arches of the foot collapse, with the entire sole of the foot coming into complete or near-complete contact with the ground. Sometimes children are born with flat feet (congenital). There is a functional relationship between the structure of the arch of the foot and the biomechanics of the lower leg. The arch provides an elastic, springy connection between the forefoot and the hind foot so that a majority of the forces incurred during weight bearing on the foot can be dissipated before the force reaches the long bones of the leg and thigh.

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The extensor digitorum brevis muscle is a muscle on the upper surface of the foot that helps extend digits 2 through 4.

<span class="mw-page-title-main">Mallet finger</span> Type of fracture

A mallet finger, also known as hammer finger or PLF finger or Hannan finger, is an extensor tendon injury at the farthest away finger joint. This results in the inability to extend the finger tip without pushing it. There is generally pain and bruising at the back side of the farthest away finger joint.

<span class="mw-page-title-main">Interphalangeal joints of the hand</span> Hinge joints between finger phalanges

The interphalangeal joints of the hand are the hinge joints between the phalanges of the fingers that provide flexion towards the palm of the hand.

<span class="mw-page-title-main">Morton's toe</span> Type of brachymetatarsia affecting the big toe

Morton's toe is the condition of having a first metatarsal bone that is shorter than the second metatarsal. It is a type of brachymetatarsia. This condition is the result of a premature closing of the first metatarsal's growth plate, resulting in a short big toe, giving the second toe the appearance of being long compared to the first toe.

<span class="mw-page-title-main">Boutonniere deformity</span> Medical condition

Boutonniere deformity is a deformed position of the fingers or toes, in which the joint nearest the knuckle is permanently bent toward the palm while the farthest joint is bent back away. Causes include injury, inflammatory conditions like rheumatoid arthritis, and genetic conditions like Ehlers-Danlos syndrome.

<span class="mw-page-title-main">Interphalangeal joints of the foot</span>

The interphalangeal joints of the foot are between the phalanx bones of the toes in the feet.

<span class="mw-page-title-main">Tailor's bunion</span> Medical condition

Tailor's bunion, also known as digitus quintus varus or bunionette, is a condition caused as a result of inflammation of the fifth metatarsal bone at the base of the little toe.

<span class="mw-page-title-main">Jammed finger</span> Medical condition

Jammed finger is a colloquialism referring to a variety of injuries to the joints of the fingers, resulting from axial loading beyond that which the ligaments can withstand. Common parts of the finger susceptible to this type of injury are ligaments, joints, and bones. The severity of the damage to the finger increases with the magnitude of the force exerted by the external object on the fingertip. Toes may become jammed as well, with similar results.

In the human foot, the plantar or volar plates are fibrocartilaginous structures found in the metatarsophalangeal (MTP) and interphalangeal (IP) joints. The anatomy and composition of the plantar plates are similar to the palmar plates in the metacarpophalangeal (MCP) and interphalangeal joints in the hand; the proximal origin is thin but the distal insertion is stout. Due to the weight-bearing nature of the human foot, the plantar plates are exposed to extension forces not present in the human hand.

<span class="mw-page-title-main">Ulnar claw</span> Deformity of the hand that develops due to ulnar nerve damage

An ulnar claw, also known as claw hand, is a deformity or an abnormal attitude of the hand that develops due to ulnar nerve damage causing paralysis of the lumbricals. A claw hand presents with a hyperextension at the metacarpophalangeal joints and flexion at the proximal and distal interphalangeal joints of the 4th and 5th fingers. The patients with this condition can make a full fist but when they extend their fingers, the hand posture is referred to as claw hand. The ring- and little finger can usually not fully extend at the proximal interphalangeal joint (PIP).

<span class="mw-page-title-main">Dynasplint Systems</span>

Dynasplint Systems, Incorporated (DSI) is a company that designs, manufactures and sells dynamic splints that are used for range of motion rehabilitation. The corporate headquarters are located in Severna Park, Maryland and it is considered a major employer in Anne Arundel County. Products are Made in the US in Stevensville, Maryland. There is a national sales force throughout the US as well as a presence in Canada and Europe.

<span class="mw-page-title-main">Syndesmosis procedure</span> Type of bunion surgery

Syndesmosis procedure is one of the more than twenty bunion surgeries currently being performed. While the majority of bunion surgeries involve the breaking and shifting of bones, syndesmosis procedure is one of few surgical techniques that use a soft-tissue or non-osteotomy (non-bone-breaking) approach to afford the same correction. More than 130 different surgical techniques have been described for correction of one single condition of the foot: the bunion deformity.

<span class="mw-page-title-main">Toe box</span> Part of a shoe

The toe box is the section of footwear that surrounds the toes on closed-toe shoes. Toe boxes that are too tight can cause injuries and foot deformities, whereas wider toe boxes may be used to treat or prevent common foot conditions such as Morton's neuroma. Toe boxes come in a variety of shapes and styles of construction, some of which are a matter of fashion, and some of which are designed for specialized functions.

<span class="mw-page-title-main">Broken toe</span> Medical condition

A broken toe is a type of bone fracture. Symptoms include pain when the toe is touched near the break point, or compressed along its length. There may be bruising, swelling, stiffness, or displacement of the broken bone ends from their normal position.

References

  1. 1 2 3 Sabrina Felson. "Understanding Hammertoes -- the Basics". WebMD . Reviewed March 31, 2019
  2. Mayo Clinic, "Hammertoe and mallet toe"
  3. 1 2 3 4 5 6 "Hammer toe and mallet toe – causes". Mayo Clinic . Retrieved 2009-01-30.
  4. Chadwick, C; Saxby, TS (December 2011). "Hammertoes/Clawtoes: metatarsophalangeal joint correction". Foot and Ankle Clinics. 16 (4): 559–71. doi:10.1016/j.fcl.2011.08.006. PMID   22118229.
  5. Ellington, JK (December 2011). "Hammertoes and clawtoes: proximal interphalangeal joint correction". Foot and Ankle Clinics. 16 (4): 547–58. doi:10.1016/j.fcl.2011.08.010. PMID   22118228.
  6. "Benefits and Risks of Hammertoe Surgery". Archived from the original on 2017-08-11. Retrieved 2017-06-29.