Hammer toe: Difference between revisions
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==Treatment== | ==Treatment== | ||
===Conservative treatment=== | ===Conservative treatment=== | ||
*In many cases, conservative treatment | *In many cases, conservative treatment is enough to resolve the condition such as: | ||
**[[Physical therapy]] | |||
**New shoes with soft, spacious toe boxes | |||
===Surgery=== | ===Surgery=== | ||
* | *In more severe or longstanding cases, [[orthopedic surgery]] may be necessary to correct the deformity<ref name="pmid29362037">{{cite journal| author=Doty JF, Fogleman JA| title=Treatment of Rigid Hammer-Toe Deformity: Permanent Versus Removable Implant Selection. | journal=Foot Ankle Clin | year= 2018 | volume= 23 | issue= 1 | pages= 91-101 | pmid=29362037 | doi=10.1016/j.fcl.2017.09.007 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29362037 }} </ref><ref name="pmid29444584">{{cite journal| author=Mueller CM, Boden SA, Boden AL, Maidman SD, Cutler A, Mignemi D et al.| title=Complication Rates and Short-Term Outcomes After Operative Hammertoe Correction in Older Patients. | journal=Foot Ankle Int | year= 2018 | volume= 39 | issue= 6 | pages= 681-688 | pmid=29444584 | doi=10.1177/1071100718755472 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29444584 }} </ref><ref name="pmid25746765">{{cite journal| author=Ceccarini P, Ceccarini A, Rinonapoli G, Caraffa A| title=Correction of Hammer Toe Deformity of Lateral Toes With Subtraction Osteotomy of the Proximal Phalanx Neck. | journal=J Foot Ankle Surg | year= 2015 | volume= 54 | issue= 4 | pages= 601-6 | pmid=25746765 | doi=10.1053/j.jfas.2014.11.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25746765 }} </ref><ref name="pmid26028601">{{cite journal| author=Basile A, Albo F, Via AG| title=Intramedullary Fixation System for the Treatment of Hammertoe Deformity. | journal=J Foot Ankle Surg | year= 2015 | volume= 54 | issue= 5 | pages= 910-6 | pmid=26028601 | doi=10.1053/j.jfas.2015.04.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26028601 }} </ref><ref name="pmid24443491">{{cite journal| author=Catena F, Doty JF, Jastifer J, Coughlin MJ, Stevens F| title=Prospective study of hammertoe correction with an intramedullary implant. | journal=Foot Ankle Int | year= 2014 | volume= 35 | issue= 4 | pages= 319-25 | pmid=24443491 | doi=10.1177/1071100713519780 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24443491 }} </ref><ref name="pmid29337598">{{cite journal| author=Obrador C, Losa-Iglesias M, Becerro-de-Bengoa-Vallejo R, Kabbash CA| title=Comparative Study of Intramedullary Hammertoe Fixation. | journal=Foot Ankle Int | year= 2018 | volume= 39 | issue= 4 | pages= 415-425 | pmid=29337598 | doi=10.1177/1071100717745854 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29337598 }} </ref><ref name="pmid25677363">{{cite journal| author=Kramer WC, Parman M, Marks RM| title=Hammertoe correction with k-wire fixation. | journal=Foot Ankle Int | year= 2015 | volume= 36 | issue= 5 | pages= 494-502 | pmid=25677363 | doi=10.1177/1071100714568013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25677363 }} </ref> | ||
==Prevention== | ==Prevention== | ||
Revision as of 16:04, 26 June 2019
| Hammer toe | |
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| A Mallet Toe is evident on the 3rd digit | |
| ICD-10 | M20.4, Q66.8 |
| ICD-9 | 735.4, 755.66 |
| MeSH | D037801 |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Sara Mohsin, M.D.[2] Cafer Zorkun, M.D., Ph.D. [3]
Synonyms and keywords: Claw toe; hammertoe syndrome; mallet toe
Overview
A hammer toe is a deformity of the second, third, or fourth toe causing it to be permanently bent at the proximal interphalangeal joint, resembling a hammer. Mallet toe is another name for this condition when affecting the distal interphalangeal joint.
Pathophysiology
- Hammer toe occurs due to abnormal (permanent) bend at the proximal interphalangeal joint of a toe due to imbalance in the muscles, ligaments, or tendons which normally hold the toe in a straight position
Risk factors
Common risk factors include:
- Advancing age
- Female sex
- Length of second toe greater than big toe
- Osteoarthritis
- Rheumatoid arthritis
- Diabetes
Complications
Few complications of hammer toe include:
- Permanent bent of the toe if not treated initially when toe is flexible
- Painful corns or calluses due to rubbing of toes against the inside of foot
Causes
Common causes of muscle, nerve, or joint damage resulting in a hammer toe include:[1][2]
- Wearing poorly-fit shoes that can force the toe against their tip, such as:
- Excessively high heels
- Shoes that are too short or narrow for the foot
- Osteoarthritis
- Rheumatoid arthritis
- Stroke
- Charcot-Marie-Tooth disease
- Diabetes
History and symptoms
- Hammer toe usually affects the second, third, or fourth toe
- Common symptoms include:
- Abnormal bend in the joint of one or more toes resembling a hammer
- Painful or difficult movement of the affected toe
- Painful calluses & corns may form (due to rubbing of hammer toes against the inside of the shoes)
Treatment
Conservative treatment
- In many cases, conservative treatment is enough to resolve the condition such as:
- Physical therapy
- New shoes with soft, spacious toe boxes
Surgery
- In more severe or longstanding cases, orthopedic surgery may be necessary to correct the deformity[3][4][5][6][7][8][9]
Prevention
Primary preventive measures for hammer toe include:
- Buying the shoes with following characteristics:
- Proper fitting
- Low heels
- Adequate toe room (avoiding shoes with pointed toes)
- More roomier and adjustable (laced or strapped shoes)
References
- ↑ Ridley LJ, Han J, Ridley WE, Xiang H (2018). "Claw toe". J Med Imaging Radiat Oncol. 62 Suppl 1: 126. doi:10.1111/1754-9485.07_12786. PMID 30309185.
- ↑ Ceccarini P, Rinonapoli G, Sebastiani E, Bisaccia M, Ceccarini A, Caraffa A (2019). "Clinical Comparison Between Shortening Osteotomy of the Proximal Phalanx Neck and Arthrodesis in Hammer Toe Surgery at Mid-TermFollow-Up". J Foot Ankle Surg. 58 (2): 221–225. doi:10.1053/j.jfas.2018.08.002. PMID 30553747.
- ↑ Doty JF, Fogleman JA (2018). "Treatment of Rigid Hammer-Toe Deformity: Permanent Versus Removable Implant Selection". Foot Ankle Clin. 23 (1): 91–101. doi:10.1016/j.fcl.2017.09.007. PMID 29362037.
- ↑ Mueller CM, Boden SA, Boden AL, Maidman SD, Cutler A, Mignemi D; et al. (2018). "Complication Rates and Short-Term Outcomes After Operative Hammertoe Correction in Older Patients". Foot Ankle Int. 39 (6): 681–688. doi:10.1177/1071100718755472. PMID 29444584.
- ↑ Ceccarini P, Ceccarini A, Rinonapoli G, Caraffa A (2015). "Correction of Hammer Toe Deformity of Lateral Toes With Subtraction Osteotomy of the Proximal Phalanx Neck". J Foot Ankle Surg. 54 (4): 601–6. doi:10.1053/j.jfas.2014.11.013. PMID 25746765.
- ↑ Basile A, Albo F, Via AG (2015). "Intramedullary Fixation System for the Treatment of Hammertoe Deformity". J Foot Ankle Surg. 54 (5): 910–6. doi:10.1053/j.jfas.2015.04.004. PMID 26028601.
- ↑ Catena F, Doty JF, Jastifer J, Coughlin MJ, Stevens F (2014). "Prospective study of hammertoe correction with an intramedullary implant". Foot Ankle Int. 35 (4): 319–25. doi:10.1177/1071100713519780. PMID 24443491.
- ↑ Obrador C, Losa-Iglesias M, Becerro-de-Bengoa-Vallejo R, Kabbash CA (2018). "Comparative Study of Intramedullary Hammertoe Fixation". Foot Ankle Int. 39 (4): 415–425. doi:10.1177/1071100717745854. PMID 29337598.
- ↑ Kramer WC, Parman M, Marks RM (2015). "Hammertoe correction with k-wire fixation". Foot Ankle Int. 36 (5): 494–502. doi:10.1177/1071100714568013. PMID 25677363.
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