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HammertoeOverview
When a person has Hammer Toe, the end of their toe bends downward and the middle joint curls up. Eventually, the toe gets stuck in a stiff, claw-like position. When the inside of your shoe rubs against a hammer toe, corns, blisters or calluses may form on top of the toe or on the bottom of your foot. This can make walking painful. You may also have pain in the joint where your big toe joins your foot. Hammer toe usually affects a person?s second toe (the toe next to the big toe), but it can affect other toes too.

Causes
As described above, the main reason people develop hammertoes is improper footwear, or footwear that is too short for the toes. Shoes that do not allow our toes to lie flat are the biggest cause of hammertoes, though there are others, including genetics, injury or trauma in which the toe is jammed or broken. Diseases that affect the nerves and muscles, such as arthritis. Abnormal foot mechanics due to nerve or muscle damage, causing an imbalance of the flexor and extensor tendons of the toe. Systematic diseases such as arthritis can also lead to problems such as hammertoe. Some people are born with hammertoes, while others are more prone to developing the condition due to genetics. If you have ever broken a toe, you know there is not much that can be done for it. It is one of the only bones in the body that heals without the use of a cast. A broken toe may be splinted, however, which may help prevent a hammertoe from forming.Hammertoe

Symptoms
The most common symptoms of hammertoes include. The toe is bent upward at the middle toe joint, so that the top of this joint rubs against the top of the shoe. The remainder of the toe is bent downward. Pain upon pressure at the top of the bent toe from footwear. The formation of corns on the top of the joint. Redness and swelling at the joint contracture. Restricted or painful motion of the toe joint. Pain in the ball of the foot at the base of the affected toe. This occurs because the contracted digit puts pressure on the metatarsal head creating callouse and pressure on the ball of the foot.

Diagnosis
A hammertoe is usually diagnosed with a physical inspection of your toe. Imaging tests, such as X-rays, may be ordered if you have had a bone, muscle, or ligament injury in your toe.

Non Surgical Treatment
People with a hammer toe benefit from wearing shoes in which the toe box is made of a flexible material and is wide enough and high enough to provide adequate room for the toes. High-heeled shoes should be avoided, because they tend to force the toes into a narrow, flat toe box. A doctor may recommend an insert (orthotic) for the shoe to help reduce friction and pressure on the hammer toe. Wearing properly fitted shoes may reduce pain and inflammation. It may also prevent ulcers from developing and help existing ulcers heal. However, the hammer toe does not disappear.

Surgical Treatment
The technique the surgeon applies during the surgery depends on how much flexibility the person's affected toes still retain. If some flexibility has still been preserved in their affected toes, the hammer toes might be corrected through making a small incision into the toe so the surgeon can manipulate the tendon that is forcing the person's toes into a curved position. If, however, the person's toes have become completely rigid, the surgeon might have to do more than re-aligning the person's tendons. Some pieces of bone may have to be removed so the person's toe has the ability to straighten out. If this is the case, some pins are attached onto the person's foot afterwards to fix their bones into place while the injured tissue heals. Following the surgical procedure, the person might have to deal with some stiffness and swelling as they pursue their recovery process. The person should also expect the toes that have been corrected to appear different following the surgery. For example; the person's toes may appear longer or shorter than they were before. The person will be advised not to pursue too much physical activity that involves their feet for some time to give their injury from surgery enough time to heal properly.
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