SOME MEDICAL FACTS
Description Hammer Toe:
A hammer toe or contracted toe is a deformity of the proximal interphalangeal joint of the second, third, or fourth toe causing it to be permanently bent, resembling a hammer. Mallet toe is a similar condition affecting the distal interphalangeal joint.
Claw toe is another similar condition, with dorsiflexion of the proximal phalanx on the lesser metatarsophalangeal joint, combined with flexion of both the proximal and distal interphalangeal joints. Claw toe can affect the second, third, fourth, or fifth toes. Onset is gradual.
Hammer toe most frequently results from wearing poorly fitting shoes that can force the toe into a bent position, such as excessively high heels or shoes that are too short or narrow for the foot.
Having the toes bent for long periods of time can cause the muscles in them to shorten, resulting in the hammer toe deformity. This is often found in conjunction with bunions or other foot problems (e.g., a bunion can force the big toe to turn inward and push the other toes). It can also be caused by muscle, nerve, or joint damage resulting from conditions such as osteoarthritis, rheumatoid arthritis, stroke, Charcot–Marie–Tooth disease, complex regional pain syndrome or diabetes. Hammer toe can also be found in Friedreich’s ataxia.
Hammertoe and mallet toe feature an abnormal bend in the joints of one or more of your toes. Moving the affected toe may be difficult or painful. Corns and calluses can result from the toe rubbing against the inside of your shoes.
The fundamental problem is a chronic, sustained imbalance between flexion and extension force of the lesser toes from intrinsic forces, extrinsic forces, or both. Hammertoe deformity primarily comprises flexion deformity of the PIP joint of the toe, with hyperextension of the MTP and DIP joints.
When a foot’s second ray is longer than the first and shoe wear does not fit correctly, flexion of the PIP joint occurs to accommodate the shoe. This length difference also causes MTP synovitis to develop from overuse of the second MTP joint. Attenuation of the collateral ligaments and plantar plate results, and the MTP joint hyperextends and may even progress to dorsal subluxation or dislocation. Rheumatoid arthritis causes hammertoe deformity by progressive MTP joint destruction, leading to MTP joint subluxation and dislocation.
Bunion can be diagnosed and analyzed by plain projectional radiography. The hallux valgus angle (HVA) is the angle between the longitudinal axes of the proximal phalanx and the first metatarsal bone of the big toe. It is considered abnormal if greater than 15–18°. The following HVA angles can also be used to grade the severity of hallux valgus:
- Mild: 15–20°
- Moderate: 21–39°
- Severe: ≥ 40°
The intermetatarsal angle (IMA) is the angle between the longitudinal axes of the first and second metatarsal bones, and is normally less than 9°. The IMA angle can also grade the severity of hallux valgus as:
- Mild: 9–11°
- Moderate: 12–17°
- Severe: ≥ 18°
Custom-molded orthotics will give the best result without invasive surgery. Orthotics are splints or regulators that when custom made for the individuals foot can not only relieve the pain of walking but realign the bones, stretch the muscle and tendon and reduce the deformity.
In some cases, conservative treatment for hammer toe include physical therapy and new shoes with soft, spacious toe boxes, the use of custom made orthotics (accommodative padding and shielding) The patient’s doctor may also prescribe some toe exercises that can be done at home to stretch and strengthen the muscles. For example, the individual can gently stretch the toes manually, or use the toes to pick things up off the floor. While watching television or reading, one can put a towel flat under the feet and use the toes to crumple it.
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Avoid Painful Surgery
In more severe or longstanding cases Hammertoe Surgery may be necessary to correct the deformity.
The Gait Analysis pages describe how each of the 12 common foot problems affect the way you walk and how this affects the physiology of your body as a whole. An awkward gait causing abnormal steps will change how your weight is distributed across your lower back and lower body joints. An awkward gait can lead to back pain, hip pain, knee pain, ankle pain & heel pain and in many cases; shoulder and neck pain! Its important to remember that your feet are the foundation that support your whole body. If the foundation is faulty, your whole body is affected.
Bio Human 3D Model
Click on the image to the left to see a 3d Bio Human model of the Anatomy and Physiology of your foot. By selecting any component of the anatomy of this model of your foot you can view it on its own. You can turn the model 360 degress, zoom in and out and strip away parts to reveal the functions of the foot. This is a medical tool and is used by doctors and surgeons world wide and accurately depicts the physiology of the human foot in detail.
Select the “click to interact in 3d” to manipulate the model. Select any anatomical component using your mouse pointer. The Anatomical component will change colour. Go to the menu that appears on your screen where you can the select different menu items that allow you to manipulate the model. Note: Edit items in the menu allow you to isolate parts, dissect parts and cross section parts of the foot anatomy.