Auteur: Podiatre Montreal
What is a hammer toe?
The hammer toe is characterized by a deformation of its joints that bend while rising. This produces friction on the shoe and causes pressure on several parts of the toe (top, bottom, tip). This pathology can affect all the toes, but more rarely the big toe. If you are experiencing pain but do not know the cause, it is best to consult your Podiatrist to treat the problem quickly for best results.
The causes are varied. Hammertoes can be caused by heredity, a muscular imbalance, and diabetes can also lead to symptoms. However, shoes that are poorly adapted to the shape of the feet are incidentally an important element of this deformity. Therefore, it is best to pay particular attention to the comfort of the shoes we wear.
The solution lies, above all, in consultation, especially when the cause of the pain or discomfort is unknown. A simple appointment at our clinic allows our foot and ankle health care professional to clarify the source of your discomfort. Similarly, he or she can advise you on the appropriate treatment or intervention.
With regard to treatments adapted to relieve the pain caused by hammertoes, we may, depending on the condition of your toes, suggest a digital or plantar orthosis; a splint may also be effective in slowing the progression of the pathology.
The direct consequences of the hammer toe on the forefoot are primarily aesthetic, but the aspect of pain is, of course, to be considered. Assuming that nothing is done to stop the cause or relieve the pain, the hammer toe will become stiffer over time, resulting in increased twitching on the top and tiptoe.
Deformed toes and poorly articulated toes can also lead to corns and horns that are prone to inflammation. The pressure exerted by a hammer toe makes the soles of the feet sensitive and can lead to permanent discomfort.
Claw toe or hammer toe? In fact, it is the same pathology which, depending on the case, causes a significant contracture of the toe or hyper-extension of the first phalanx leading to the flexion of the other phalanges.
The hallux valgus, also known as “onion”, can promote the appearance of the hammer toe. This protrusion on the side of the foot causes the bone to deviate outward. The big toe slants inward and even overlaps the second toe. Simple solutions can greatly improve the situation. Do not hesitate to consult the doctor of our podiatric clinic.
Hammer toe surgery
Should an operation be considered to end the problem of claw or hammer toes? The question does indeed arise. Only an evaluation in a podiatric clinic can enlighten your decision. Our doctor, podiatrist, has all the necessary expertise to analyze the seriousness of your foot condition and discuss with you the most appropriate solutions.
Of course, several treatments relieve pain and slow the progression of this abnormality, however, if you wish to eliminate this hammertoe condition once and for all, surgical correction is required. Three procedures are feasible and depend on the positioning of the toe, the contracture of the toe (is it excessively curved?); its rigidity, etc.
The toe can be straightened with a claw or hammertoe through arthroplasty. This involves removing part of the bone of the curved joint. This procedure, which requires the removal of half of the joint, does however provide some post-operative range of motion.
Digital arthrodesis, on the other hand, is accomplished by surgical fusion of the joint. Part of the bone is removed so that the toe joins in a straight and rigid position, preventing movement in the toe joint.
The tendon transfer repositions the toe normally. The procedure consists of moving the tendon from the bottom of the foot to the top of the toe so that it unfolds and stretches towards the ground. This operation is occasionally performed in combination with one of the other two.
Some more serious cases require relaxation of the tendon of the upper foot and the joint under the toe. Removal of the base of the phalangeal bone (or shortening of the metatarsal bone) may also be necessary in cases of severe rigidity.
In all situations, this is a decision that requires responsible discussion with your Podiatrist, as surgery is a last resort. Our doctor podiatrist is a remarkably competent and experienced surgeon who will be able to answer your questions and help you decide between the strengths and weaknesses of the various options.
Pain, anaesthesia and convalescence… Although any surgery is accompanied by pain and swelling, anesthesia techniques (usually local) and analgesics adapted to your situation exist and will be prescribed if necessary.
Day surgery. Patients go home the same day in the majority of cases. Better yet, their stay lasts only a few hours. Surgical correction of hammertoes usually does not require a cast. The length of recovery time varies with each person.
Resumption of activity is gradual after hammer toe surgery. Usually, patients walk with crutches after three or four days. However, mobility remains limited for a couple of weeks. It becomes possible to wear a suitable shoe after two to eight weeks, depending on the patient.
The swelling goes down after six to eight weeks. The healing process takes a year, but the foot is almost completely healed by about the fourth month. Of course, driving, returning to work, physical activity and other activities depend on your ability to perform various actions such as braking hard, working standing, etc. The recovery process takes about a year, however, the foot is almost fully recovered by the fourth month.
Alternative to hammer toe surgery
It is possible to prevent and treat hammertoes naturally. A consultation in a podiatric clinic can provide you with simple solutions to your problem such as the use of splints, foot orthotics, not to mention the sound advice that an experienced podiatrist such as our doctor can give you.
The foot orthosis is an orthopedic device that corrects, compensates and preserves the functions of the foot. The hammer toe can become painful, but it can also lead to other complications (through instability of the foot) in the knees, hips and back.
Wearing proper footwear, as a reminder, is part of the natural treatment of hammertoes. If your toes get stuck in your shoes, it is not okay at all. Talk about it with your Podiatrist.2021