Hammer toe: Difference between revisions
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{{SK}} Claw toe; hammertoe syndrome; mallet toe | {{SK}} Claw toe; hammertoe syndrome; mallet toe | ||
==Overview== | ==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]]. | A '''hammer [[toe]]''' is a [[deformity]] of the [[second]], third, or fourth [[toe]] [[Causes|causing]] it to be permanently [[Bent bond|bent]] at the [[proximal interphalangeal joint]], resembling a hammer. '''Mallet [[toe]]''' is another name for this [[condition]] when [[Affect|affecting]] the [[distal interphalangeal joint]]. | ||
==Pathophysiology== | ==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 | *Hammer toe occurs due to [[abnormal]] (permanent) [[Bends|bend]] at the [[proximal interphalangeal joint]] of a [[toe]] due to [[imbalance]] in the [[muscles]], [[ligaments]], or [[tendons]] which normally [[Holdfast|hold]] the [[toe]] in a [[Straight, Incorporated|straight]] [[Position effect|position]] | ||
==Risk factors== | ==Risk factors== | ||
Common risk factors include: | Common [[risk factors]] include: | ||
*Advancing age | *Advancing [[age]] | ||
*Female sex | *[[Female]] [[Sex (activity)|sex]] | ||
*Length of second toe greater than big toe | *[[Length]] of the [[second]] [[toe]] greater than the [[big toe]] | ||
*Osteoarthritis | *[[Osteoarthritis]] | ||
*Rheumatoid arthritis | *[[Rheumatoid arthritis]] | ||
*Diabetes | *[[Diabetes]] | ||
==Complications== | ==Complications== | ||
Few complications of hammer toe include: | [[Fewmets|Few]] [[complications]] of hammer [[toe]] include: | ||
*Permanent bent of the toe if not treated initially when toe is flexible | *Permanent [[Bent bond|bent]] of the [[toe]] if not [[Treatments|treated]] initially when [[toe]] is [[Flexibility (anatomy)|flexible]] | ||
*Painful corns or calluses due to rubbing of toes against the inside of foot | *[[Painful]] [[Corns & calluses (patient information)|corns or calluses]] due to rubbing of [[toes]] against the inside of [[foot]] | ||
==Causes== | ==Causes== | ||
Common causes of muscle, nerve, or joint damage resulting in a hammer toe include:<ref name="pmid30309185">{{cite journal| author=Ridley LJ, Han J, Ridley WE, Xiang H| title=Claw toe. | journal=J Med Imaging Radiat Oncol | year= 2018 | volume= 62 Suppl 1 | issue= | pages= 126 | pmid=30309185 | doi=10.1111/1754-9485.07_12786 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30309185 }} </ref><ref name="pmid30553747">{{cite journal| author=Ceccarini P, Rinonapoli G, Sebastiani E, Bisaccia M, Ceccarini A, Caraffa A| title=Clinical Comparison Between Shortening Osteotomy of the Proximal Phalanx Neck and Arthrodesis in Hammer Toe Surgery at Mid-TermFollow-Up. | journal=J Foot Ankle Surg | year= 2019 | volume= 58 | issue= 2 | pages= 221-225 | pmid=30553747 | doi=10.1053/j.jfas.2018.08.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30553747 }} </ref> | Common [[causes]] of [[muscle]], [[nerve]], or [[Joint (anatomy)|joint]] damage [[Result|resulting]] in a hammer [[toe]] include:<ref name="pmid30309185">{{cite journal| author=Ridley LJ, Han J, Ridley WE, Xiang H| title=Claw toe. | journal=J Med Imaging Radiat Oncol | year= 2018 | volume= 62 Suppl 1 | issue= | pages= 126 | pmid=30309185 | doi=10.1111/1754-9485.07_12786 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30309185 }} </ref><ref name="pmid30553747">{{cite journal| author=Ceccarini P, Rinonapoli G, Sebastiani E, Bisaccia M, Ceccarini A, Caraffa A| title=Clinical Comparison Between Shortening Osteotomy of the Proximal Phalanx Neck and Arthrodesis in Hammer Toe Surgery at Mid-TermFollow-Up. | journal=J Foot Ankle Surg | year= 2019 | volume= 58 | issue= 2 | pages= 221-225 | pmid=30553747 | doi=10.1053/j.jfas.2018.08.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30553747 }} </ref> | ||
*Wearing poorly-fit shoes that can force the toe against their tip, such as: | *[[Wear red day|Wearing]] poorly-fit [[Shoe insert|shoes]] that can [[force]] the [[toe]] against their [[Tippy toes|tip]], such as: | ||
**Excessively high heels | **Excessively high [[Heel|heels]] | ||
**Shoes that are too short or narrow for the foot | **[[Shoe insert|Shoes]] that are too short or narrow for the [[foot]] | ||
**[[Osteoarthritis]] | **[[Osteoarthritis]] | ||
**[[Rheumatoid arthritis]] | **[[Rheumatoid arthritis]] | ||
| Line 50: | Line 50: | ||
==History and symptoms== | ==History and symptoms== | ||
*Hammer toe usually | *Hammer [[toe]] usually involves the [[second]], third, or fourth [[toe]] | ||
*Common symptoms include: | *Common [[symptoms]] include: | ||
**Abnormal bend in the joint of one or more toes resembling a hammer | **[[Abnormal]] [[Bends|bend]] in the [[Joint (anatomy)|joint]] of one or more [[toes]] resembling a hammer | ||
**Painful or difficult movement of the affected toe | **[[Painful]] or difficult [[Movement disorder|movement]] of the [[Affect|affected]] [[toe]] | ||
**Painful calluses & corns may form (due to rubbing of hammer toes against the inside of the shoes) | **[[Painful]] [[Callus (cell biology)|calluses]] & [[corns]] may form (due to rubbing of hammer [[toes]] against the inside of the [[Shoe insert|shoes]]) | ||
==Treatment== | ==Treatment== | ||
===Conservative treatment=== | ===Conservative treatment=== | ||
*In many cases, conservative treatment is enough to resolve the condition such as: | *In many [[Case-based reasoning|cases]], conservative [[Treatments|treatment]] is enough to resolve the [[condition]] such as: | ||
**[[Physical therapy]] | **[[Physical therapy]] | ||
**New shoes with soft, spacious toe boxes | **[[New]] [[Shoe insert|shoes]] with soft, spacious [[toe]] [[Box|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> | *In more severe or longstanding [[Case-based reasoning|cases]], [[orthopedic surgery]] may be [[Necessary and sufficient|necessary]] to [[Corrective|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== | ||
Primary preventive measures for hammer toe include: | [[Primary prevention|Primary preventive]] [[Measure (mathematics)|measures]] for hammer [[toe]] include: | ||
*Buying the shoes with following characteristics: | *Buying the [[Shoe insert|shoes]] with following [[Characteristic impedance|characteristics]]: | ||
**Proper fitting | **Proper fitting | ||
**Low heels | **Low [[Heel|heels]] | ||
**Adequate toe room (avoiding shoes with pointed toes) | **Adequate [[toe]] room ([[Avoidance response|avoiding]] [[Shoe insert|shoes]] with [[Point (geometry)|pointed]] [[toes]]) | ||
**More roomier and adjustable (laced or strapped shoes) | **More roomier and adjustable (laced or strapped [[Shoe insert|shoes]]) | ||
==References== | ==References== | ||
Revision as of 16:29, 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 the second toe greater than the 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
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:
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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