Hammertoe can be life-changing, treat it in time

May 26 13:38 2020 Print This Article

Hammer-toe, also called mallet-toe or claw-toe is a condition in which one or more toes of the feet are bent and upraised at the centre. This causes discomfort and pain while walking, and also affects the appearance of the feet. If not treated in time, the condition can become severe, requiring costly surgery followed by a long rehabilitation period. 

Causes

The skeleto-muscular system comprises bones, muscles, ligaments and tendons which are all connected to each other. They work in perfect coordination with each other to achieve the desired motion. When any one of these structures is under severe strain, or not properly developed, it results in a deformity.  That is precisely what happens with hammertoe. 

When one or more of your toes, or the entire foot is squeezed for a long time, it results in an imbalance in the muscles, ligaments and tendons that hold your toes flat. The muscles holding the toe may either weaken or tighten creating an imbalance. As a result, the toes bend horizontally or vertically, or both, to relieve their discomfort. Over time, this bend becomes permanent, creating a claw, hammer, or mallet-like shape of the toe. The condition is more common in the second, third and fourth toe than the great or the little toe. 

Common causes

• The wrong footwear: Pointed shoes in men or women, and high-heeled shoes in women are the most common culprit. They crowd your toes into a space in which they can’t lie flat. As a result, they curl-up and retain this curled position even after removing the footwear
• Trauma: An accident or injury where the toe collides with, or is jammed by, a hard object can cause you to break the toe, or develop hammertoe.
• Activities that create imbalance: Professional or leisure activities that force you to walk on tiptoe, sit, stand or walk in an abnormal fashion can squeeze the feet in unusual ways, creating a hammertoe over time. 

Risk Factors

As described above, the wrong choice of footwear, and trauma, can lead to hammertoe. So they are also the biggest risk factors. Other risk factors include

• Toe length. If the second toe is longer than the big toe, there is a higher risk of developing hammertoe
• Gender – For reasons unknown, women are more likely to develop hammer toe than men
• Certain ailments: Arthritis and those with diabetes are more prone to developing foot deformities 
• Age – The risk of hammertoe increases with age. 
• Genetics – In some families, there may be a history of hammertoe which increases the risk

Types

• Flexible hammertoes: These are in the early stage of development in which case, the affected toes are still able to move at the central joint. Simpler treatment options will work to relieve the condition 
• Rigid hammertoes; Due to long-term abuse of the feet, the tendons tighten and the joints become misaligned as well as rigid. Surgical options are the only way to relieve this condition

Complications

• If not treated in time, the person may start walking with a limp to relieve discomfort. This shifts the body-weight in unusual ways causing other orthopaedic problems
• The deformed toe starts scraping against the footwear at the top, causing corns, calluses, bunions, redness or swelling
• The above sores can develop infection and pus formation
• If you suffer from diabetes or peripheral arterial disease, the infected sores can lead to conditions such as cellulitis or osteomyelitis
• Due to the unsightly appearance of the feet, the person may avoid social gatherings
• When social gatherings cannot be avoided, the person tends to push the feet behind and out-of-sight while sitting. This puts a lot of strain on the knees. 

Prevention

• Avoid footwear that tends to squeeze your feet and leave less room for the toes. Avoid footwear that tends to bend the feet, as in the case of high-heels. Wear low-heeled shoes and flatter shoes always. Use laced or strapped shoes that allow you to adjust the tightness. Always choose footwear that complements the natural curve of the feet. 
• Check your feet size from time to time, to ensure you are not wearing lower-sized footwear. Buy footwear in the evenings as the feet would have swollen up slightly by then.
• Avoid any professional or leisurely activity which requires you to bend, twist or squeeze your feet in unhealthy ways
• If you have had an injury to the toes or feet recently, do not ignore the same. Meet a physiotherapist and undergo therapy to relieve the pain. Also get an X-ray taken, to rule out fracture of one or more toes. 

Treatment

Treatment options vary depending on how severe the condition is. 

• Therapy: You will be asked to perform simple exercises that make use of simple equipment. These exercises stretch and flatten the toes, while also strengthening the muscles and ligaments that hold up the toe. Gradually, the muscles, ligaments and tendons all start aligning themselves to their original and natural position. 
• Foot-aids: The doctor may prescribe shoe-inserts, corn-pads and foot straps to relieve the pain and force proper movement of the toes
• Medication: The doctor may prescribe pain-killers and medicines to treat the infection and soreness in the toes, before undertaking therapy or surgery. 
• Surgery: Depending on the severity of the condition, a podiatric surgeon may pursue one or more surgical options such as Arthroplasty, Arthrodesis, Tendon transfer, Basal phalangectomy and Weil osteotomy. These techniques work on the bones, joints and tendons that make up the deformed toe. 

Seek expert help

As is clear, hammertoe is not a simple condition that can be ignored. It has long-term implications that are life-changing. 

Consult a reputed hospital if you or any of your near ones suffer from hammertoe. Such hospitals have a podiatrist or foot specialist on their rolls. Such a specialist will diagnose your condition carefully and prescribe the right course of treatment for best results.

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

Chennai – 044 4000 6000 • Trichy – Cantonment – 0431 4077777 • Trichy – Heartcity – 0431 4003500 • Trichy – Tennur – 0431 4022555 • Hosur – 04344 272727 • Salem – 0427 2677777 • Tirunelveli – 0462 4006000 • Bengaluru – 080 6801 6801