With the summer officially in full swing many men and women are shedding their shoes and unveiling some unsightly feet. Corns, calluses, hammer toes, bunions just to name a few of the most common ailments. The past few weeks several friends and family members have been seeking my advice about their hammer toes all with the same questions; why do I have them? Can they be fixed? How do I fix them? And when do I know it is time for them to be fixed?
As always I like to start out with short anatomy lesson. There are three bones in each of your lesser toes and they are called phalanges. These three bones meet up to form two small joints, they may be referenced as the “PIPJ” and “DIPJ”. Hammer toes occur with a muscle imbalance in those small toes that cause these joins to contract and fix the toes in a bent position. Sometimes your hammer toe can be flexible where you are able to straighten it out with your hand or it straightens when you step down. Other times they can be rigid or fixed in that position.
Why they form can be a combination of causes. Ill-fitting shoes that are too small will cause the toes to contract, repeatedly wearing shoes that are too small will encourage tightening and shortening of those muscles in the toes and induce a deformity. Other causes include arthritic conditions, neurologic disorders, diabetes, trauma.
As always I like to start out with short anatomy lesson. There are three bones in each of your lesser toes and they are called phalanges. These three bones meet up to form two small joints, they may be referenced as the “PIPJ” and “DIPJ”. Hammer toes occur with a muscle imbalance in those small toes that cause these joins to contract and fix the toes in a bent position. Sometimes your hammer toe can be flexible where you are able to straighten it out with your hand or it straightens when you step down. Other times they can be rigid or fixed in that position.
Why they form can be a combination of causes. Ill-fitting shoes that are too small will cause the toes to contract, repeatedly wearing shoes that are too small will encourage tightening and shortening of those muscles in the toes and induce a deformity. Other causes include arthritic conditions, neurologic disorders, diabetes, trauma.
Once the contracture of the toe forms there is little to nothing you can do to reverse or improve the deformity. Small steps to prevent hammer toe s included getting your foot measured regularly before buying new shoes and making sure that you have adequate room in the toe box of your shoes. There are different pads and taping techniques that will temporarily provide relief but that is literally putting a Band-Aid on the problem and not correcting it. You can reduce pain and prevent further hammering with accommodative shoes but the only way to actually reverse or correct the current deformity is surgery. Hammer toe surgery is extremely common and probably the most common foot surgery performed.
The surgical procedure will vary slightly according to each patient but the fundamentals are the same. The goal is to release the contracture at the toe. This is achieved by a combination of releasing the short and tightened tendons and by resecting a portion of the small bones at the joints to make room at the joint allowing the toe to straighten. Variations included having a simple arthroplasty ( just resection of the bone), pinning of the toes to hold the correction with a removable pin and even using a small metal implant that will remain permanently to straighten the toe. These variations depend on the severity of the hammer toe, the patient goals and activities. You can discuss these options further with your podiatric surgeon to see which plan is right for you.
The surgical procedure will vary slightly according to each patient but the fundamentals are the same. The goal is to release the contracture at the toe. This is achieved by a combination of releasing the short and tightened tendons and by resecting a portion of the small bones at the joints to make room at the joint allowing the toe to straighten. Variations included having a simple arthroplasty ( just resection of the bone), pinning of the toes to hold the correction with a removable pin and even using a small metal implant that will remain permanently to straighten the toe. These variations depend on the severity of the hammer toe, the patient goals and activities. You can discuss these options further with your podiatric surgeon to see which plan is right for you.
I tell my patients, friends and family the right time to fix your hammer toes are when they become painful and or interfere with your everyday life. If you want to wear shoes that are reasonable and your toe deformities prevent this, or if you are unable to participate in certain exercises or activities then you should consider hammer toe correction.
Length of recovery time will depend on the surgical procedure chosen. You will been given a hard bottom shoe post operatively and will have stitches in place for approximately two weeks. That part is pretty routine and uniform. The amount of time you will be refraining from full activity will depend on procedure performed, your doctor and your natural recovery abilities.
Length of recovery time will depend on the surgical procedure chosen. You will been given a hard bottom shoe post operatively and will have stitches in place for approximately two weeks. That part is pretty routine and uniform. The amount of time you will be refraining from full activity will depend on procedure performed, your doctor and your natural recovery abilities.