Hammertoes are a deformity in which one or more toes of the foot are bent in a fixed Z-shaped position.

Characteristic features:

  • Flexion at the proximal interphalangeal joint.
  • Overextension at the metatarsophalangeal and distal interphalangeal joints.
  • A visual resemblance to a hammer

Most often, the second toe of the foot is affected, but other toes can also be affected.

Such pathology can make it difficult to choose shoes, cause pain, and limit a person's activity. People with this pathology often have low self-esteem, physical discomfort, difficulty walking, and have trouble moving comfortably.

Types of Hammertoes

Hammertoes can manifest in different types, forms, and degrees of severity, which determines the choice of treatment methods.

The main types are

  1. Hammer toe: the most common pathology. The shape of the toes resembles a trigger or hammer, with a typical callus formation on the back of the interphalangeal joint.
  2. Mallet toe: the ridges of the hammer toe become L-shaped with a permanently bent distal phalanx and painful corns on the end.
  3. Claw deformity: the curvatures take the form of raised hooks.
  4. Clinodactyly: curvature, mainly of the second toe in the horizontal plane.
  5. Taylor's bunion deformity: the structures of the little toe are inward-facing, with the appearance of a "bone" on the outer surface.

Forms of manifestation

  • Flexible form. The initial stage of the disease. Curvature can be straightened manually, and the shape can change when wearing comfortable shoes.
  • Rigid form. The deformation becomes more stable and does not lend itself to an independent correction. The toes retain their curvature even without pressure or wearing shoes.
  • Combination forms. Some patients may have a combination of flexible and rigid deformities in different toes and at different stages of development.

Understanding the different types of bone structure curvature allows doctors to choose the most effective treatment strategies that are tailored to each patient's individual needs and disease severity.

Causes of Hammertoes

Many factors contribute to the development of the pathology.

  1. Heredity is one of the main factors.
  2. Tight, improperly sized shoes.
  3. Age factor - more often manifests itself after 50 years.
  4. Background inflammatory diseases (rheumatoid arthritis, gout, osteoarthritis, etc.).
  5. Diabetic foot.
  6. Joint injuries and fractures.
  7. Muscle imbalance and disorder of the functional state of the foot.
  8. Developmental anomalies of the feet.

Each patient may have unique combinations of factors that lead to the development of the condition. Depending on the causes, the doctor can choose the most effective treatment methods and prevent further progression of the disease.

Symptoms and Signs

Hammer toes can manifest through a number of symptoms and signs, including:

  1. Pain and discomfort: pain in the toe area, especially when walking or standing for long periods of time. The pain may be associated with pressure on the joints and soft tissues.
  2. Change in the shape of the toes: the curvature takes a hammertoe shape, where the toe tips look downward.
  3. Hyperextension of joints: joints may bend backwards, which increases the deformity.
  4. Limitation of mobility: deformed joints can limit the mobility of the foot and make it difficult to walk.
  5. Difficulty putting on shoes.

Visible changes:

  • the toes appear unnaturally curved;
  • skin over the deformed joints may be rough or inflamed;
  • blisters and calluses due to rubbing against shoes or neighboring toes; calluses may appear on curved toes, adding to discomfort and pain.

Early recognition of the symptoms of the disease is important to start treatment in time and prevent further progression of the deformity. Patients experiencing these symptoms are advised to see a physician for evaluation and the development of an individualized treatment plan.

Diagnostics: Understanding the Condition

Diagnosis of hammer toes involves various methods to determine the extent of the deformity and select the optimal therapy plan.

  1. Physical examination: identifying visible signs of deformity and determining the severity of the condition.
  2. Clinical tests: assessment of foot function and pain level; measurement of range of motion, which helps to determine the extent to which the pathology affects the patient's daily activities.
  3. Radiography: determining the degree of deformity and assessing the condition of the bones and joints. This method allows doctors to see structural changes and assess the need for surgical intervention.
  4. MRI: for additional evaluation of the soft tissues, joints and tendons of the foot, identifying associated pathologies (inflammation or lesions).
  5. Ultrasound: used to visualize the structures of the foot - tendons and joints—and assess their condition. Which is necessary for additional diagnosis and treatment planning.

The combination of these methods allows doctors to accurately diagnose hammer toes, determine their causes, and develop an individualized treatment plan for each patient.

Treatment Options for Hammertoes

Depending on the degree of pathology, different methods are used to eliminate the deformity - treatment of hammertoe without surgery, the conservative method, or with the use of modern surgical techniques.

Conservative treatment

Medication: anti-inflammatory drugs and injections of glucocorticosteroids to relieve inflammation and reduce pathological symptoms. Physiotherapy sessions.

The use of a number of orthopedic devices:

  • orthopedic insoles;
  • toe extender
  • silicone and synthesized inserts between the toes;
  • gel toe orthoses;
  • corrector socks (straighteners).

In advanced cases of deformity, both minimally invasive hammer toe surgery and reconstructive surgeries are used.

  1. Arthrodesis (joint fusion): the surgeon fixes the joint surfaces to correct the defect.
  2. Arthroplasty (joint replacement): replacing the joint with an artificial joint.
  3. Osteotomy (bone fracture): surgery to correct the shape of the toes.
  4. Tenotomy (tendon cut): reducing stress on the tendon.
  5. Hammertoe correction: removal of part of the bones, tendons, or joints, and straightening of the toe to restore its normal form and function.
  6. Splinting: fixing the toe in the correct position using external devices for support and correction.

Conservative and surgical treatment can be used individually or in combination, depending on the severity of the pathologic symptoms.

Before deciding on the treatment of hammer toes, it is important to consult with a qualified specialist who can help you choose the most appropriate treatment plan for each individual case. Illinois Foot & Ankle has vast experience in treating hammertoes, please feel free to schedule a consultation with Dr. Alex Yanovskiy, DPM at (847) 298-3338

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