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HammertoeOverview
A Hammer toes is a deformity that causes your toe to bend or curl downward instead of pointing forward. This deformity can affect any toe on your foot; however, it most often affects the second toe or third toe. Although a hammertoe may be present at birth, it usually develops over time due to wearing ill-fitting shoes or arthritis. In most cases, a hammertoe is treatable.

Causes
Flat feet can result in hammertoes, this is due to poor mechanics off the foot. High arched feet can also result in buckling toes. A major cause is in hereditary, all the toe conditions mentioned could be acquired due in hereditary factors. Bunions are a major cause of hammertoes. Claw toes are usually the result of a shoe that is too short. For many people, the second toe is actually longer than the great toe, and if shoes are sized to fit the great toe, the second (and maybe even the third toe) will have to bend to fit into the shoe. Shoes that are pointed make matters even worse. Combine pointed shoes with high heels, the foot is under similar pressure as if it was constantly being pushed downhill into a wall. Rheumatoid arthritis can also lead to bunions, which in turn can lead to hammer toes.Hammer Toe

Symptoms
A toe (usually the second digit, next to the big toe) bent at the middle joint and clenched into a painful, clawlike position. As the toe points downward, the middle joint may protrude upward. A toe with an end joint that curls under itself. Painful calluses or corns. Redness or a painful corn on top of the bent joint or at the tip of the affected toe, because of persistent rubbing against shoes Pain in the toes that interferes with walking, jogging, dancing, and other normal activities, possibly leading to gait changes.

Diagnosis
The exam may reveal a toe in which the near bone of the toe (proximal phalanx) is angled upward and the middle bone of the toe points in the opposite direction (plantar flexed). Toes may appear crooked or rotated. The involved joint may be painful when moved, or stiff. There may be areas of thickened skin (corns or calluses) on top of or between the toes, a callus may also be observed at the tip of the affected toe beneath the toenail. An attempt to passively correct the deformity will help elucidate the best treatment option as the examiner determines whether the toe is still flexible or not. It is advisable to assess palpable pulses, since their presence is associated with a good prognosis for healing after surgery. X-rays will demonstrate the contractures of the involved joints, as well as possible arthritic changes and bone enlargements (exostoses, spurs). X-rays of the involved foot are usually performed in a weight-bearing position.

Non Surgical Treatment
Treatment options for a hammertoe are based on the severity of the condition. A hammertoe caused by inappropriate footwear can be corrected by wearing properly fitting shoes. If a high arch caused the condition, wearing toe pads or insoles in your shoes can help. These pads work by shifting your toe?s position, which relieves pain and corrects the appearance of your toe.

Surgical Treatment
If a person's toes have become very inflexible and unresponsive to non-invasive means of treatment and if open sores have developed as a result of constant friction, they may receive orthopaedic surgery to correct the deformity. The operation is quick and is commonly performed as an out-patient procedure. The doctor administers a local anesthetic into the person's foot to numb the site of the operation. The person may remain conscious as the surgeon performs the procedure. A sedative might also be administered to help calm the person if they are too anxious.Hammer Toe

Prevention
How can I prevent hammer toe? Avoid wearing shoes that are narrow or don?t fit well. Also, don?t wear heels higher than 2 inches. Instead, choose shoes with a wide toe box that give you ? inch between the end of your longest toe and the inside tip of the shoe. Check often to make sure your child?s shoes fit, especially when he or she is having a growth spurt.

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